Autoimmune disease (hashimotos) and a failed fresh transfer

[TTC301]

Hi,

I have an autoimmune disease (hashimotos) and it affects my thyroid. My TSH has been under control for some months and I had my first fresh transfer in July. That sadly ended in a chemical. From my understanding there are 3 reasons why it didn't work (chromosomal issues, not enough progesterone, or that my body attacked the embryo) the latter being because of the high inflammation in my body from my autoimmune.

For my first frozen transfer in October, I asked to be put on steroids for a short period to try and reduce the inflammation in my body to ensure my body doesn't attack the embryo (as well as increased progesterone, pessaries and lubion) and normal meds like oestrogen.

Originally the doctor seemed to be against me being on steroids short term (3 weeks in the lead up to the transfer) but after I asked him to get a 2nd opinion it was decided I did need them.

Has anyone ever taken steroids before there FET? or have an autoimmune disease and have anything they could share that would help me? any info welcome X

Hi @TTC301 I have a borderline thyroid disorder (TSH was a little high but not enough for NHS to treat, and I have high TPO antibodies) which led me to see a reproductive immunologist who tested my NK cells and they're high (apparently thyroid antibodies and NK cells are often linked) so I've been on prednisolone since day 10 of my FET cycles.

The first one didn't work, the 2nd did, same approach with steroids so just luck/something else that made number 2 work I guess! Both pgta tested as well.

I stayed on full dose prednisolone until 14 weeks and am now weaning off those. I've been on a lot of IVF meds so couldn't tell you what side effects I've had from what bur I haven't noticed an issue on the steroids

Initially my plan was going to be intralipid infusions rather than steroids but then I ended up taking the steroids, they're a lot cheaper as well

Thank you @Orangewillow for responding!

when you say day 10 of your FET cycle do you mean 10 days after starting progesterone or after transfer?

my clinic only want me to be on prednisolone for 3 weeks and no longer which is causing me concern because I thought a longer period would be better. do you know why they allowed you to stay on them up till 12 weeks? Mine keep referring back to side effects which seem so minor in comparison to everything else.

So day 1 is when my period started, I didn't downregulate for my FETs, I then had scans/took oestrogen and on day 10 or thereabouts started in the prednisolone, with the rough timeline that on day 14 of my cycle I'd trigger, start progesterone, then have the embryo transfer a week later (i think, cant quite remember the timings now!

When my first FET didn't work I came off the prednisolone pretty quick, but generally I've heard of people staying on it when pregnant until around 12 weeks - I've seen some people start to wean off at 8/10, my doctor said usually he'd say 12 but because I did a retest and my levels were still a bit high, to stay on until 14 weeks

I know its not ideal to be on long term, but 3 weeks sounds short esp as surely in early pregnancy you want it to do its job.

I'll have been on the steroids just over 3 months by the time I'm done so its not that long anyway, I'm def no expert though, just going with what my Dr said! I'm sure they've made me bloated and gain weight, but so have the IVF drugs, haven't noticed anything else

@Orangewillow with your first FET that failed how long were you on prednisolone for prior to the transfer? If you don’t mind me asking, did you have a chemical or did it not stick?

yes I feel 3 weeks is short too - it’s so hard because I’m quite good at advocating for myself but when you have experienced doctors telling you 3 weeks is enough it’s like where do I go from there?! This is the first time using the steroid though for me.

I am also on Levothyroxine daily for my thyroid so not sure if the steroids would play a part in effecting them.
X

For the FET that didn't work I started the prednisolone on day 10, because I didn't respond well to the oestrogen and my lining was being difficult, my transfer was 25 days after that. That one just didn't stick. After that, I hs a hysteroscopy to remove scar tissue which they thought was why my lining had been so slow to build and not a great thickness, I reckon that's probably the reason (aside from just bad luck) that embryo didn't stick

In the FET that did work, I started the prednisolone on day 9 of my cycle, and had the transfer 6 days later (that was on IVF stims and my lining got decent quickly, so it all moved a lot faster)

Everything I've read about women taking steroids for pregnancy has them on it until the early pregnancy is established, to help prevent an early loss, maybe your Dr can explain why they think 3 weeks will do it - maybe you don't need so much immune suppression? But if you take it for 3 weeks from pre transfer, surely that only gets you to the end of the TWW? I'd push for more info/a second opinion. I know not all doctors believe in steroids/immune stuff, but it seems odd to me to say yes to it but only for 3 weeks. Sorry can't be more help there, but I hope there's some helpful info from my experiences