BFP IVF cycle 7 - weaning off clexane and steriods

[Gretal81]

After many years and IVF cycles, we got our first BFP - very grateful but also extremely anxious and nervous that it won't stick.

It was a natural FET with trigger shot and utrogestan pessaries (2 morning and evening). Whilst I did not have the immune tests, I have 3 autoimmune conditions and was previously told I had sticky eggs. I went to Reprofit in the Czech Republuc for this round and asked to be put on clexane (one injection per day) and steroids (prednisolone 10mg).

The clinic has suggested that I wean myself off the clexane, prednisolone and utrogenstan from week 8 and stop completely at week 10. I am so so so nervous about this. Please could you share your protocals for weaning off these medications?

When I was at clinics in the UK, prednisolone was weaned off by week 12 - and I've read lots online about being weaned off between weeks 10-12. Any advice would be helpful

thank you

[Viletta]

Congratulations on your BFP! I'm in Reprofit too but yet to see a bfp. I'd suggest contacting your clinic to explain how you feel and see if you could extend the meds till week 12 when you have your scan. Good luck!

[Botanica]

I was told by my consultant that there was little evidence for additional progesterone and Prednisalone beyond twelve weeks but due to my anxiety levels and history of previous loss I managed to extend the time I was on them and am now weaning off at 28 weeks.

There is a case for coming of steroids as they can cause high blood pressure and a risk of gestational diabetes so if you are on them for longer your hospital may want extra monitoring. Whenever you do come off them, you need to wean off slowly rather than just stop - I went from 10mg, to 7.5 for a week, to 5mg for a week, to 2.5mg for a week before stopping completely.

Why do they want to stop the Clexane? As a blood thinner the case for needing this does not diminish throughout the pregnancy. If you need it at the start I would think you need it throughout as it can guard against small clots forming in the placenta and cord and in your own body. Most doctors prefer you stay on it until about six weeks post petunia, stopping 12 hours before delivery and restarting after the birth.
Are you taking low dose aspirin too? This can also be beneficial, especially as it can cross the cord to the baby, whereas Clexane cannot.

[Gretal81]

Thank you for your responses @Viletta and @Botanica.

I e-mailed the clinic with my concerns and the response was that new research has shown that the extra drugs are not necessary and the body starts to take over the role of the drugs. Must admit that I find this very vague. Does this hold through for progesterone as well as the steroids and clexane? I think not! However, the coordinator did say I can stay on them (all) for longer if I wanted!

I think it is the case that progesterone production is taken over by the plancenta but I am taking steroids for autoimmune and clexane for blood flow. I spoke with a friend who is a midwife and she also suggested that it may be possible I will be on clexane for a lot longer - but suggested if I missed a couple of weeks (I am running low) it should not matter.

Your dose reduction for the steroids sounds very sensible Botanica and I think I will follow this too from week 10 -12.

Thanks for your responses again, much appreciated.

@Viletta - fingers crossed for you - this was my 4th cycle at Reprofit and 7th overall, just in case that helps - first ever BFP

@Botanica - congratulations on your pregnancy - long time dipper into these threads and really pleased you have your BFP - lots of luck and strength for the duration of your pregnancy

[hoping2018]

I would think your pregnancy will be classified as higher risk due to all the drugs - so could you not use this to be referred to consultant on nhs and let them decide what to do about your meds? I know you’ve had it done abroad but you will be under nhs care for this pregnancy / may give you peace of mind! Wishing you a smooth pregnancy xxx

[TwinkleStars15]

@Gretal81 do you mind me asking what dose of Clexane you are on? I also have to take Clexane during pregnancy (I’m not pregnant currently) but only 40mg which seems quite low to me.

[Gretal81]

@hoping2018 - yes high risk on every factor, unfortunately! thanks so much for your suggestion re: the nhs consultantant, it will most definately give me peace of mind to have the decision taken away from me! Again, I've seen your advice on these threads, always solid and thoughtful - thank you ;)

@TwinkleStars15 - Don't mind at all. I am also on 40mg - I started on the day of transfer. I am not sure but it seems pretty standard, the reason I say this is because at the clinic the prescriptions for clexane are pre-made and they were all for 40mg. Fingers crossed for you x