Steroids, ivf and covid

[imeanwhy]

I am trying to reach a decision...

We are about to start a fet ivf cycle with our last viable (PG tested) embryo. We won't be doing any further cycles, so it's truly a last chance (we are lucky to have one beautiful DC already).

We have gone through 4 previous, unsuccessful, fet cycles (most natural ivf). now I have been recommended to do a medicated one for "more control". I have high thyroid antibodies and the doctor recommended steroids for about 7-8 days around the transfer. They have been offered to me in the past but I always refused as I wasn't convinced they would help - DC1 was conceived without them. And nobody seems to confirm that they are necessary. It's always "to cover all bases".

I worry a lot about side effects - mostly long term as they have been associated with diabetes later. But given it's our last ever chance, I am wondering if I should try them. It will be short term use.

My question is: is it mad to consider suppressing my immune system during a pandemic? I am vaccinated but would that help if I am taking them? I just cannot shake the worry that I will put myself in harm's way. If you have taken steroid for ivf during the pandemic, did you take any extra measures to protect yourself?

Yes, me, and we took steps to shield etc. Thankfully both wfh. Haven’t caught covid due to being careful thankfully.

Technically we aren't "in" the pandemic anymore compared to 2 years ago though - life has pretty much gone back to normal - if you are in the U.K. - and presumably you are triple vaccinated then having covid is nothing more serious than catching a cold now? (In fact I've had worse colds)

I did my 5th and final round in June 2020 still in lockdown - I was told if I wanted to take steroids though we'd have to wait up to 12 months to do it as they were refusing proscribing them due to the risk at the time of immune suppressant drugs and covid - I elected to carry on without them rather than wait and was successful

But in your situation I'd take the steroids since it's your last cycle - you'll only end up wondering "what if" if you don't and the transfer fails x

@twinsetandpearl yes totally, I get it that we are in a much better situation than we were in two years ago. But the virus is still around and we are safe due to immunity and vaccines. So if I compromise my immunity, would that put me in danger? I guess that's what I am thinking. I have had covid and it's been fine as I am jabbed and boosted and all that. I am in the UK.

Unfortunately I cannot shield as I have a primary school aged kid (that's how we got covid first time round, through school) and I have to go into, public transport and the office - no wfh. Oddly it might have been an easier decision if we were in lockdown ha as I could control my contacts more for a couple of weeks and it would have been ok.

Congratulations on your successful round though how lovely!

@Fiefofum good luck! Hope it works out for you. Glad you didn't get it! Were you able on them for long?
Do you know by any chance how long it takes for natural immunity to kick start again after stopping them?

Covid is always going to be with us and the steroids they give you are very low dose in comparison to someone who take's prednisolone for an auto immune disorder like lupus - you also only take them for a few weeks - most clinics taper off by 12 weeks if not before so long term effects are very minimal x

Thanks for your thoughts... I am so so divided. One day I wake up convinced I will take them and the other that I won't.

I wonder if there's anybody out there with raised thyroid antibodies who managed to conceive without steroids - either through ivf or natural...

I was on a low dose of prednisone for my previous transfer (which failed anyways) and I didn't develop any side effects. I didn't catch covid either and I work with people/teenagers and use public transportation.
I agree with twinsetandpearl. The dose is very low.
I am supposed to take them again for my next transfer and I will. I was reassured both by my consultant and the immunologist that side effects are minimal as long as I follow their protocol.

Hi @Yuliaaa thank you for your thoughts, it's helpful. If you don't mind me asking, how long were you on them for? I am so sorry your transfer failed. I have been there and suffice to say it's not a good feeling... good luck with the next one!

@imeanwhy I was on them for 3 weeks. The only restriction was not to use salt at all. I was scared about the side effects too, but my consultant was reassuring and told me not to worry.
I do understand you worries though. In the end it's personal choice.
Thank you for your nice thoughts and good luck with your transfer! 🍀

I've been taking 25mg of steroids on and off for a year as well as other immune modulators. You are only immunosuppressed when you've been on steroids consistently for 4 weeks and then you have to wean off. If they're only prescribing them for a week around transfer, I wouldn't be too concerned as it will be quite a low dose.

Oh that's interesting @VenusStarr I didn't realise that the dose and period meant I wouldn't be "properly" immunocompromised. I thought no matter what the dosage, it just works that way... I have emailed my clinic for some clarity on a couple of these points from their perspective as I feel I have been reading confused 🤦‍♀️

*have confused myself by over googling, I meant

@imeanwhy I had prednisone for my last FET which unfortunately ended In a miscarriage. I didn't get any side effects from them nor was I being extra safe. I just went on as normal (still mask wearing of course) but yeah all was fine with my. I'm about to have them again for next fresh cycle coming up in a few weeks and I'm not planning on doing f anything different.
Hope all goes well for you! X

I was on them for 16 weeks as part of an immune treatment plan after many losses. I’m pretty sure this plan helped me have my dc. I never got covid or so much as a cold despite other dc being at the bug filled nursery. I was on 25mg

Also immune conditions often flare on a second pregnancy a few immune specialists told me this. Like when you get stung by a bee , you normally get anaphylactic reaction with the second bee sting