Experimental Treatment for Recurrent Miscarriage

khenders · 12-30-2007, 06:53 PM

I have had 5 known mc and feel at this point, i wont get a sticky bean again unless i have some sort of medical intervention. I have had all the testing done except for karotyping which will cost me about 2 k out of pocket. I have been doing research for treatment of recurrent miscarriage and have found some interesting treatments. Is there any one here who has had recurrent undiagnosed cause of mc who has had some sort of treatments to lead to a healthy baby?

here are some of the treatments i have been coming up with.

some experimental treatments for recurrent miscarriage are:

Intravenous Immunoglobulin (IVIg)
IVIg has been used to treat both pre-implantation and post-implantation recurrent pregnancy loss associated with elevated levels of antiphospholipid antibodies, antithyroid antibodies, circulating NK cells and NK cell killing activity and embryotoxins. It has also been used for treatment of unexplained recurrent implantation failure and pregnancy loss. The mechanisms by which IVIg works include:
· IVIg provides antibodies to antibodies (anti-idiotypic antibodies)
· IVIg suppresses B cells production of autoantibodies
· IVIg enhances regulatory T cell activity
· IVIg suppresses NK cell killing activity

Intralipid
Evidence from both animal and human studies suggest that intralipid administered intravenously may enhance implantation and maintenance of pregnancy. Intralipid is a 20% intravenous fat emulsion used routinely as a source of fat and calories for patients requiring parental nutrition. It is composed of 10% soybean oil, 1.2% egg yolk phospholipids, 2.25% gylcerine and water. Intralipid stimulated the immune system to remove “danger signals” that can lead to pregnancy loss. The appeal of Intralipid lies in the fact that it is relatively inexpensive and is not a blood product. Its likely benefit to IVF patients with immunologic dysfunction is under evaluation.

Phosphodiesterase Inhibitors (viagra)
The phosphodiesterases are responsible for enzymatic degradation of molecules within the cells involved in generating energy for the cell to function. They have anti-inflammatory effects. Two phosphodiesterase inhibitors—Sildenfil (Viagra) and Pentoxiphylline (Trental) have been shown to increase blood flow to the uterus. Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. Significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who had previously experienced repeated IVF failures and who responded to the Viagra. Similar results were obtained when Trental was used in 400mg twice a day doses alone with vitamin E to treat women experiencing implantation failure associated with thin endometrium and elevated uterine NK cells. Animal studies have demonstrated that pentoxifylline prevents miscarriages in abortion-prone mice. Efficacy of pentoxifylline for treatment of recurrent pregnancy loss in human beings remains to be established.

Aspirin
Low-dose aspirin (80mg or 1 baby aspirin) alone has used for treatment of both repeat implantation failures and post-implantation pregnancy losses.

Steroids
Steroid therapy in the forms of prednisone, prednisolone and dexamethasone has been used to prevent both pre-implantation pregnancy failure and post-implantation pregnancy loss. Steroids are routinely administered in many IVF programs.

Linda_G · 12-30-2007, 07:11 PM

I am so sorry for all of your losses, I can't imagine the heartbreak you have been through *hugs*.

I haven't done any of the treatments personally, but I did know one lady who did IVIg after 7 m/c and now has a 2.5 year old dd. Wether her situation or reasons for m/c were the same as yours I don't know, but at least that is one success story right?

I hope you get some answers and more importantly, a sticky sticky bean soon...

take care

Linda
2 m/c

khenders · 12-30-2007, 07:16 PM

thanks linda. i have seen the story of one lady who had 10 m/c who had ivf with preimplantation genetic diagnosis and had a healthy baby. thanks for the story.

lachicarubia · 12-30-2007, 07:32 PM

Keva,
You listed baby aspirin as one of these experimental treatments. Were you taking baby aspirin during this last pregnancy?

I know that you were taking progesterone, but I don't understand why your bbs stopped hurting right before your m/c, because I thought that the progesterone is what caused the sore bbs. How much prometrium were you taking? Maybe you need a larger dose, or maybe a different form of progesterone would be better for you.

Since you said that you had a yeast infection, you might want to consider the following information. According to the following website, yeast eats up progesterone:

Quote:

Progesterone - Ever wonder why so many women have to use progesterone cream? It is because fungus devours it and changes it into prednisone. In fact, Dr. Doug Kaufman MD & scientist plus an author reports that drug companies farm fungus colonies, feeding them progesterone to make the drug prednisone which they then sell to consumers as a remedy for everything.
http://www.candidayeastkillers.com/greatest-threat.htm

I hope and pray that you will find the right treatment that will help you get your sticky BFP.

uwalcott · 12-30-2007, 07:51 PM

OMG lachia I have a yeast infection right now and I am TTC #2 that really scares me that candida can cause a miscarriage. I always thought yeast infections were a sign you might be pregnant so I was kinda happy about it (thought it sucks to hell cuz it hurts, burns and itches LOL).

khenders · 12-30-2007, 07:55 PM

cara i was on 200 mg a day. My p4 levels were 40ish. I was wondering the same thing when my boobs stopped hurting. I was not on aspirin.

RunnerDuck · 12-30-2007, 08:18 PM

I am a little skeptical of yeast eating up progesterone. Just because it helps yeast to grow doesn't mean it will eat up what is in your body and cause miscarriage. Not saying that CAN'T mean it but I am really, really skeptical and I would not worry too much about yeast leading to miscarriage. (FWIW I had a raging external yeasty thing going on last week - the kind where you lay on the couch and claw at yourself until your labia is 3 times its normal size - and my babies are still in there baking away)

Hormonal fluctuations can cause yeast infections, hence they are more common when pregnant or on BCP. But more women than not probably survive yeast infections without miscarrying, and if yeast really "ate up" progesterone it seems like you'd see more BCP failures if women got yeast while on BCP. Might be interesting to see if there is a link between yeast and BCP failure but I would be surprised.

As for the progesterone and sore boobs - with this pregnancy my p4 started at 187 or something absurd. I was also taking 4 200mg prometriums vaginally a day (won't affect blood levels) I did not have sore boobs. The presence or absence or sore boobs does not indicate the presence or absense of sufficient progesterone. Symptoms can come and go for no reason.

With regard to aspirin and prednisone - I took both this pregnancy. The aspirin was for testing for MTHFR (clotting factor) and the prednisone was kind of a "what the hell" sort of thing. 10mg once a day has been shown to help with repeat loss and/or implantation failure. Personally - I don't think I can say for sure that either of them was responsible for my pregnancy. This was the first cycle we used Menopur only - I think it gave me the best quality eggs. With my miscarriages I had one blighted ovum, one chemical pregnancy, and one loss at 8 weeks where the numbers were NEVER good... betas slow to take off, p4 crappy from the start (12, I think?) The blighted ovum was a spantanious pregnancy but the others were medicated, just not with menopur. I really think I was making lousy eggs and even though I tested as having the MTHFR and borderline for one of the cardiolipid antibodies - I don't know that I think that was my problem. But I do think the aspirin and prednisone may be worth a shot since they're cheap and not likely to hurt anything.

The other treatments... such as IVIG... I am skeptical. One of the guys who was really big on this - Beer? Beers? - had a clinic right near me and I was actually going to go for a consult... he's dead but the clinic is still there, it's actually in the same office as where I go for laser hair removal... but... I just don't know. I didn't believe in my gut that that would solve my problem. I have read too many mixed things that he was never able to prove there was a significant improvement in pregnancy rates with these treatments and in some cases patients actually did worse. I heard from someone else who was going to go here that this guy really throws the same diagnosis and treatment at everyone. Basically you and your husband aren't compatible, let's send your husband's stuff off to this lab in Iowa or Chicago or something, lets get you going on XYZ expensive treatment. I guess if you have that kind of money to throw at the problem you may as well but I just couldn't make myself believe it would help me. In the end I think the right ovulation induction meds are what I needed.

So... the aspirin and prednisone... by all means I say go for it. The other stuff I would look long and hard at before deciding.

Have you been getting pregnant on you own all these times or with meds? I would consider different means of inducing ovulation... which i feel like sounds like such an easy, idiotic solution... but for me, I really think it is what mattered.

I am so sorry you have had another loss.

lachicarubia · 12-30-2007, 08:20 PM

uwalcott, I think that as long as your progesterone is high enough, or if you are taking enough supplemental progesterone, yeast can't cause a m/c.

Keva, I think that is what I was taking too, 100mg am and 100mg pm. If your progesterone was high enough, and if you were taking enough prometrium, then I would definitely try adding baby aspirin when you start your next 2ww. Since being a part of these boards, I have seen several ladies who have had early m/c's finally achieve a sticky bean when they add baby aspirin, progesterone, or both.

khenders · 12-30-2007, 09:26 PM

runnerduck i have been having clomid 150 mg to induce ovulation. did you have IVF?

caradefinitely considering aspirin and oral predisone or uterine prednisone treatment. also looking at the intralipid since it is cheap as well.

lachicarubia · 12-30-2007, 10:54 PM

I don't understand how steriods could help prevent a m/c. What is the rationale behind this Tx?

RunnerDuck · 12-30-2007, 11:04 PM

I didn't do IVF, just injectables, several cycles. We were going to move on to IVF but it was another one of those things were I wasn't convinced it was what I needed... in retrospect I wish we had just gone to IVF because I probably wouldn't have ended up with triplets. Oh well! If/when we try again we will probably go right to IVF unless by some magical fluke my body decides to O on its own. A girl can dream right?

Steroids are anti-inflammatory and suppress immune response and thus keep you from rejecting the embryo, if that is a problem. Low dose steroids also lower male hormones which can help with ovulation and egg quality.

khenders · 12-30-2007, 11:54 PM

cara some women have increased cells called natural killer cells that can attack the fetus as foreign body to cause m/c. Steroids help decrease these natural killer cells and also the production of antibodies. some women can produce antibodies against spouses dna (which is passed to fetus).

kidrobot · 01-01-2008, 09:55 AM

Keva I just wanted to say how sorry about your last loss. I saw that you got pg and thought hooray this is it for her. I'm so sorry.

khenders · 01-01-2008, 12:05 PM

THANKS kidrobot, it has been tough, just taking it day by day!

RunnerDuck · 01-01-2008, 01:50 PM

What kind of doctor are you seeing, an RE or an OB? Something that comes to mind is clomid can cause estrogen issues so some women take estradiol the first trimester or whatever of the pregnancy. Has this been addressed? It's another shot in the dark but also another one of those things that might help, probably won't hurt, you know?