PLEASE HELP! Prednisone - which days?

[doglover13]

Hi all,

We've been TTC for 19 mos. now. I'm wondering if anyone was prescribed prednisone. I've heard it can help the egg implant because it suppresses the immune system. If you were on it, which cycle days did you take it for, and in what dosage?

 

[MrsJD]

Hi honey

I was on prenisolone for uterine natural killer cells, however I didn't start this until after my positive test.

I took B6 100mg and wellsprings progesterone cream prior to my as this helps implanation.

X

 

[doglover13]

Thank you so much for the quick reply. I really appreciate it! Mad, mad congratulations on your current pregnancy. Keeping my fingers and toes crossed for you...

 

[oliveoyl]

I've started this cycle on pred, doxycycline and aspirin.
Prednisolone from day 7 of cycle, continuing until either 12 weeks PG or end of 4 cycles.
I am on 20mg daily and we are TTC without any ART at present.
I haven't had uterine biopsy for NK cells but our FS was happy to treat empirically for 4 cycles, then will need biopsy if no luck.
Hope this helps

 

[doglover13]

Thank you so much. This is EXACTLY what I wanted to know. Thanks again!

 

[oliveoyl]

You're welcome doglover13 - I hope the steroids do the trick for you and you don't experience any side effects.

 

[grneyednurse]

Do you have immune issues that have messed with your fertility?

 

[doglover13]

Do you have immune issues that have messed with your fertility?

That is a good question. I have sensitivities to several foods, (all soy prods and derivatives, peanut, a few tree nuts, strawberries), and a few drug allergies, (clindomycin, neomycin, benzoyl peroxide). It took a few years to sort it all out. Meanwhile, I was on low-dose prednisone (2 mg/day), to keep the hives at bay. Now, I control reactions through my diet, but I'm wondering if there's a possible underlying inflammatory condition. Any thoughts?

 

[oliveoyl]

It certainly sounds possible......
I have had immune testing (other than natural killer cell/uterine biopsy) and all normal, but since TTC have had 7 early pg. losses and developed psoriasis, which is an immune condition. Immune causes of infertility/ART failure/miscarriage are only a relatively new field of medicine, but I am hopeful that it is our 'issue', and the steroids will help.

 

[doglover13]

It certainly sounds possible......
I have had immune testing (other than natural killer cell/uterine biopsy) and all normal, but since TTC have had 7 early pg. losses and developed psoriasis, which is an immune condition. Immune causes of infertility/ART failure/miscarriage are only a relatively new field of medicine, but I am hopeful that it is our 'issue', and the steroids will help.

I'm so sorry to hear about your losses. I hope it goes better with the steroids. I just started taking prednisone 3 days ago, 5mg 2x/day, because I think I may have immune/rejection problems as well. When my body reacts to something, it tends to overreact, almost violently. I have also hear that, if you've been with your partner for a long time, it's more likely that you'll develop antibodies to his sperm. IDK if this is true.

Keeping my fingers crossed for you!

 

[grneyednurse]

Wow, that really sucks not knowing if this is your problem or not. Have you been tested for immune issues? I wouldn't take that nasty prednisone without knowing though. It has way too many side effects without having a diagnosis. I would think the longer one has been with their hubby if they were to develop antibodies (as with any allergy) it would be true as far as that goes.....can you go to a doctor to be tested for this? I would die not knowing if this were my problem.

 

[oliveoyl]

Thanks doglover13 - I really hope it helps. My chart is looking amazing, but I'm too scared to test! https://www.fertilityfriend.com/home/202c37 It's certainly worth a go with the steroids and I hope it works for you. Why the dose twice daily - I read to take in the am as if you take it later in the day it can cause insomnia xx

Grneyednurse - yup, it sucks. We have tried all the other less invasive things, so now for the steroids. Although the side effects are potentially nasty, so is a miscarriage every second month for the last year, so for us its the better of the evils, and gives us hope. Also, many women take steroids during pregnancy for conditions like rheumatoid arthritis, and the side effects can generally be managed (I'm a Dr). There is testing available for immune issues. I just worry that there are so many things we don't understand about the immune system, and its role in fertility, and that even having a negative test doesn't rule out immue issues.

xx

 

[doglover13]

Wow, that really sucks not knowing if this is your problem or not. Have you been tested for immune issues? I wouldn't take that nasty prednisone without knowing though. It has way too many side effects without having a diagnosis. I would think the longer one has been with their hubby if they were to develop antibodies (as with any allergy) it would be true as far as that goes.....can you go to a doctor to be tested for this? I would die not knowing if this were my problem.

I know prednisone is seriious stuff, but I'm gonna give it a go for the next two weeks, (or until my next period), and see if it helps. I have to check if there are any minimally invasive tests for immune.antivody issues. I hate the s/e, and am familiar with them, (weight gain, irritability, muscle/joint aches), but it's worth it to me to try it.

 

[doglover13]

Thanks doglover13 - I really hope it helps. My chart is looking amazing, but I'm too scared to test! https://www.fertilityfriend.com/home/202c37 It's certainly worth a go with the steroids and I hope it works for you. Why the dose twice daily - I read to take in the am as if you take it later in the day it can cause insomnia xx

Grneyednurse - yup, it sucks. We have tried all the other less invasive things, so now for the steroids. Although the side effects are potentially nasty, so is a miscarriage every second month for the last year, so for us its the better of the evils, and gives us hope. Also, many women take steroids during pregnancy for conditions like rheumatoid arthritis, and the side effects can generally be managed (I'm a Dr). There is testing available for immune issues. I just worry that there are so many things we don't understand about the immune system, and its role in fertility, and that even having a negative test doesn't rule out immue issues.

xx

Wow, your chart looks like a textbook pregnancy chart so far! I can see why you're scared to test, though. In the early months, I tested way too early and often. Now, I hold olut until my period is due. I am sick of staring at one naked, lonely line.
You're a doctor -- how cool. Would you mind telling me what kind of tests there are? Can they test for antibodies to particular sperm? I just have a gut feeling my body is attacking his sperm. I don't know why...I love the guy, that's for sure! LOL! It's just a weird feeling. IDK why I'm splitting the dose. Insomnia, huh? That explains the tossing and turning for the past two nights!

 

[grneyednurse]

I know oliveoyl, that is why i asked her first if she KNOWS she has an issue, as taking the steroids without knowing the problem could cause more. I am just saying to find out the problem first, then treat. I hope you would agree.

 

[oliveoyl]

Thanks doglover13 - I caved and just tested...... and got a very feint line on a first response test just now. Here's hoping the steroids do their thing and help our lucky #8 stick this time. I am not sure of your situation, but I have had recurrent miscarriages so had the associated testing. We've had semen analysis, our karyotypes done, tests for autoimmune and clotting disorders, HSG to check tubes and I had an MRI (for other uterus issue probably not associated with early losses). The only testing I haven't had is uterine biopsy, though this is quite easy and is done a few days before your AF, just like a pap smear but I imagine a little more uncomfortable. OF our testing, we found I had a hydrosalpinx in one tube (this can cause MC) so had this removed in June, but have had 2 early losses since. All our other tests have been normal, but an immune mechanism is very likely given the nature of our losses and my development of other immune mediated problems recently. Regarding antisperm antibodies, they can do testing for this. Are you under the care of a fertility specialist?

Regarding the dosing, most people I've talked with about prednisolone take it in the morning to reduce any issues with insomnia. I assume you also know about titrating the dose slowly if you are planning on stopping the pred, or you can get very sick.

Grneyednurse - I agree that testing is important, but I think it is also important to acknowledge the limitations of testing. If there is one thing that I have learned as a health professional on this rollercoaster of infertility is that it is all well and good to follow the clinical evidence, but as the patient I have found I am more willing to 'give things a go' even if the evidence is not great. This seems to be the case often in fertility medicine as there is so much that is unknown at this time. All that said, the protocol I am on is a protocol that is offered to those who have recurrent unsuccessful ART cycles and is being monitored carefully be an experienced specialist. Thanks for your input on these important issues.

 

[doglover13]

Thanks doglover13 - I caved and just tested...... and got a very feint line on a first response test just now. Here's hoping the steroids do their thing and help our lucky #8 stick this time. I am not sure of your situation, but I have had recurrent miscarriages so had the associated testing. We've had semen analysis, our karyotypes done, tests for autoimmune and clotting disorders, HSG to check tubes and I had an MRI (for other uterus issue probably not associated with early losses). The only testing I haven't had is uterine biopsy, though this is quite easy and is done a few days before your AF, just like a pap smear but I imagine a little more uncomfortable. OF our testing, we found I had a hydrosalpinx in one tube (this can cause MC) so had this removed in June, but have had 2 early losses since. All our other tests have been normal, but an immune mechanism is very likely given the nature of our losses and my development of other immune mediated problems recently. Regarding antisperm antibodies, they can do testing for this. Are you under the care of a fertility specialist?

Regarding the dosing, most people I've talked with about prednisolone take it in the morning to reduce any issues with insomnia. I assume you also know about titrating the dose slowly if you are planning on stopping the pred, or you can get very sick.

Grneyednurse - I agree that testing is important, but I think it is also important to acknowledge the limitations of testing. If there is one thing that I have learned as a health professional on this rollercoaster of infertility is that it is all well and good to follow the clinical evidence, but as the patient I have found I am more willing to 'give things a go' even if the evidence is not great. This seems to be the case often in fertility medicine as there is so much that is unknown at this time. All that said, the protocol I am on is a protocol that is offered to those who have recurrent unsuccessful ART cycles and is being monitored carefully be an experienced specialist. Thanks for your input on these important issues.

Congrats!, I'm crossing my toes, the dog's paws, etc. for you!
To answer your Q's, I was under the care of an RE, and took a break from the meds to let my body normalize, but now I'm going to go back. I haven't been pregnant yet, as far as I know. There was one cycle where I'm pretty sure I conceived, but we lost it very early. I think I will request a test for antisperm antibodies. Thanks for the heads-up; I didn't know the test existed. I know about titrating the prednisone, because I was on it for a food allergy before. Today, I switched to taking all 10mg in the a.m., so hopefully it'll alleviate the sleep issues. I feel so hormonal this month, like period is about to come, but it's not due for another week. Then again, I felt this way for the first time last month, and wasn't pregnant, so I guess it doesn't mean anything.
Are you taking prednisone and progesterone now?

 

[honeyz]

Hi I would like to know if anyone has had suspected immune issues and taken just the steroids either predisalone dexmethasone or any other steriod but not taken any other immune therapy or drugs and got a bfp. I would especially be interested in anyone who has never had a bfp and has had long term trying to concieve unexplained issues.

Also I would like to know pplz experiences of taking the steroids which side effects they got at what dose and did all the side effects completley dissapear after stopping the steroid or hav some side effects remained permanantely?

thank you for takin ur time to reply ur experiences would be greatly appreciated

 

[Smiler13]

Hi ladies,

Am interested in this thread as I have experienced four early pregnancy losses in the last year and am having dilemmas about tests and treatments.

Oliveoyl, I agree, these are important issues and fertility testing and treatments for recurrent m/c are a minefield. Thank you for your informative posts - is reassurring that all this is difficult even for qualified medical professionals! I hope that this time works out for you.

I have seen two RMC specialists who are dubious about immunological issues / prednisolone, say there isn't the evidence, there are side-effects for the baby etc. etc.

It makes it so difficult that drs have different opinions and approaches. As a non-scientist and not being able to read any relevant scientific studies, articles etc. I'm not sure how far I personally want to go in terms of "empirical" / more controversial approaches. It is something I'm carefully considering and am interested in others' experiences and viewpoints.

To make it even more complex, my husband has slightly different views and is an optimist, isn't keen on the more controversial tests and treatments, whereas I think I'm more "give it a go".

I have been trying to find somewhere doing the uterine biopsy (privately, I'm not eligible for the NHS trial in Liverpool) for NKCs, but not managed to find anywhere yet.

Mrs JD (she has a pregnancy journal) is taking prednisolone after RMC and is 17 weeks along - am sure would be happy to share her perspective, will get in touch with her if I can work out private messaging / forwarding links etc.!

 

[oliveoyl]

Hey girls, this month was not meant to be - lovely BFP yesterday but then AF started - bring on 2010!

Doglover - Sounds like a visit back to your FS would be a good idea. How's your sleep now? I hope you don't mind me asking but how long have you been TTC? My FS said that there was no evidence that progesterone supplementation reduces risk of miscarriage as the cause of low progesterone is a non-viable pregnancy, but I haven't read the literature myself. Fingers crossed for you that you get your xmas BFP.

Honeyz - welcome. I have just done my first 'natural' cycle with 20mg prednisolone in the morning (+100mg aspirin + doxycycline days 2-12) for suspected immune issues . I got a BFP this month, but another chemical preg (our issue). In terms of side effects I haven't experienced any really. There are many potential side effects, some serious, but these can usually be managed and need to be weighed against the potential benefits. It is my understanding that most side effects will resolve when ceased, but issues such as bone density and skin changes may be permanent. Worth a good long chat with your doctor.

Smiler - sorry you have had four pg losses in the last year, it just sucks doesn't it. I hope you get your sticky one soon. As for this area of fertility - it is a minefield, and really in its infancy with regards to good quality research. I am currently reading Dr Beers book on immune issues ("Is your body baby friendly?") which discusses the evidence. 20+ years ago leading FS thought IVF wouldn't work, so there is always hope. Regarding steroids many women take them during pregnancy without major issues, but it is a personal decision. I figure that without trying this treatment, we may never get the chance to have children, and it is a risk I am willing to take. Our next option is IVF/ICSI to look at whether embryo quality is our issue, but I figure the drugs used in this treatment are not without their own risks (and the financial and emotional costs) so would like to try less invasive methods first. Although it is difficult if your parther feels otherwise. It is encouraging as you point out that there are trials for this therapy currently underway - good luck trying to get on one. I have been in contact with Mrs JD and her story keeps me going.

Thinking of you all at this tough time of year xx