Intralipids or pred?!

[Groundhoghcg]

Hi all. After six miscarriages (and one living child conceived pregnancy #4) I've been diagnosed by Dr Thum at the Lister Hospital with high and overly active NK cells.

The tests show I'm 'lucky' that pred or intralipids would be equally effective for me. I know many ladies under Prof Shehata end up on both..

I feel daunted by the side effects of pred. The idea of facing another miscarriage plus rapid weight gain and moon face feels quite mean, but then despite the tests I don't quite feel reassured than an IV fat emulsion will do the job?

Any thoughts? I've always found there's so much experience and knowledge on these boards.

Hi @Groundhoghcg.

I'm sorry to hear about your miscarriages 😢.

Are you my twin? I've also had numerous miscarriages (4), have one child and am under Dr Thum with exactly the same diagnosis and treatment.

I'm 6+3 pregnant just now but think I might currently be experiencing another miscarriage - bleeding started a few hours ago, I feel numb and can't believe it... I actually have a thread going myself but can't face updating it.. (but will send you a link as several people on the thread rook pred and found it very helpful).

Anyway, as for your question: I had the exact same dilemma as you. Due to concerns about my weight (I'm overweight unfortunately due to years of treatment for an autoimmune condition and mobility problems), Dr Thum and I decided that I would go on pred very briefly only ie from BFP to 'tie me over' until intralipids could be arranged. I'm very far from his clinic so arranged intralipids locally to me - but since I can't have the private nurse who has agreed to do the intralipids on call 24/7 in case of a BFP, I asked Dr Thum if I could go on pred for a week or two between BFP and starting intralipids (which seems to be a vulnerable time for me as I seem to have early losses).. to bridge the gap between BFP and intralipids. Dr Thum was happy with this plan, I got my meds, and when I got my BFP I arranged the intralipids.

But I then suddenly didn't want to do intralipids anymore; just a gut feeling. Plus steroids suppress symptoms of my autoimmune condition so I worried if we stopped pred my auto immune issues would flare.. It just suddenly felt strange swapping a treatment that was working for another one. At that point I was approx 4.5 weeks pregnant, so I had another consultation with Dr Thum. He was fine with me staying on pred as long as my weight doesn't go up significantly and my BP is okay, so am monitoring both and so far so good.

I don't seem to have the moon face yet. I have been on steroids before and have definitely had it but at that point I wasn't very careful with eating whilst I have been very careful with my eating this time round. I am feeling quite hungry but have just tried to eat healthy food and not over eat. I had a few nights of waking up in the middle of the night and not being able to get back to sleep which I'm sure was due to the steroids but that seems to have stopped. I also thought at one point I could feel my heart beating excessively but again I don't notice it anymore. Overall the pred is making me feel really good (it prevents symptoms of my autoimmune condition) so that's a bonus and I seem to have a lot of energy and zero morning sickness - usually pregnancy makes me very ill. And it's a lot less expensive.

Having said all that, since I might be miscarrying it might not be working for me so I might not be the best example. But lots of folks who are on it seem to say it's what made the difference in their successful pregnancies..

One other negative is I currently have what must be a chest infection, and I'm really quite unwell with it which I assume I picked up because of massively lowered immunity.

I hope this is helpful. I'll try to post a link to my (not yet updated) thread so you can see what others have said about pred (haven't seen anyone comment about intralipids)..

www.mumsnet.com/Talk/miscarriage/4989281-think-theres-a-shadow-of-a-line-and-need-to-know-to-start-meds-after-many-losses

Not sure if this is working

@DancinOnTheCeiling that's so helpful thank you. I am leaning towards pred..

I'm so sorry you're bleeding. You will have done all the googling I have and you'll know that bleeding in pregnancy is common and doesn't mean you're miscarrying - I completely understand the trauma and feeling of doom though.

Do you think you'll ask for another scan?

@Groundhoghcg sorry to hear about your miscarriages, I took pred on cycle #7 and cycle #9 after being diagnosed with high nk cells and didn't notice any weight gain other than what was normal for pregnancy, I think you have to be on it for a lot longer and much higher doses for the moon face to develop. I had some very fine hair on the sides of my face but that disappeared quickly when I weaned off the steroids. My problems conceiving turned out to be due to an undiagnosed autoimmune disease which I only discovered after I had finished ivf so the steroids were definitely what I needed and I had successful pregnancies both times I took it.

Thanks @MissSmiley out of nosey-ness what dose were you on?

Thanks @Groundhoghcg. For me, bleeding has always been bad news, so I'm preparing myself for the worst. My scan situation is actually a bit all over the place, will update my own thread as don't want to derail yours.

Hope you can make a decision re pred and that other people will post some more helpful info. 😍

Hi. My Consultant has just suggested steroids and intralipids. Just wondered how these have made people feel,if it feels like lots of extra work on top of the rest of the ivf transfer meds and perhaps most importantly if you were advised to socially isolate because of the dampened immune system whilst using them? Thank you.

@Prayformiracles I have just done one dose of intralipids and a week of steroids and feel fine apart from feeling a bit tired although it is early days.

Has anyone ever been unsuccessful with a protocol theyve been prescribed? I've been diagnosed with borderline low natural killer cells. Last month I took a dose of intralipids 2 days before i ovulated, progesterone from 3 dpo and prednisolone from 7 dpo. For the first time ever i didnt get a positive pregnancy test this month (follows 6 chemical pregnancies). Is this a sign the medication is too much? Has anyone ever experienced this?

@Rose1411 How are you doing? I just wondered why you did pred and intralipid when you have borderline low nk cells? From what I read uterine nk cells shouldn't be too high or too low for a successful pregnancy. Although it's not clear if blood nk cell levels are correlated with uterine nk cells, I'd expect one doesn't surpress the immune system further if the reading is already on the lower side. Did your doctor explain the reason? Xx

Just curious, what dose of pred is everyone on and for how long?