Adding DHEA can cause miscarriages, implantation disfunction…

28 01 2013

from here: http://www.preventmiscarriage.com/Blog/2012/December/Increased-DHEA-linked-to-Poor-Decidualization.aspx

“A group in Washington recently published an article that links increased DHEA found in patients with PCOS with poor decidualization – the failure to properly prepare the endometrial lining for pregnancy. The article showed that high levels of DHEA found in PCOS patients led to poor decidualization by inhibiting an enzyme necessary for proper development of the decidua, this enzyme is called G6PD. Proper decidualization is determined by measuring levels of markers in the endometrium that were associated with normal development of decidua (PRL and IGFBP1).

DHEA administration lowered the levels of these markers and may be the mechanism by which PCOS affects implantation and leads to the significantly higher rate of miscarriage in this group of patients (it is also interesting to note that Lovenox treatment increases the production of these same markers, and may be the mechanism for its success in PCOS patients not related to its anti-coagulation affect). Metformin treatment has also been shown to reverse this effect of DHEA.

Individuals using DHEA supplements to improve egg quality and to increase egg numbers should also be aware of these issues negative affects on the endometrium as well. This continues to make it clear that a thorough understanding of all the mechanisms of how PCOS syndrome can lead to miscarriages is necessary for the correct treatments to be administered. “

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Great post at Fertility Lab Insider:

23 01 2013

Wonderful post about how you can act to increase accessibility of fertility treatments here.

HereDeixis – In linguistics, deixis refers to the phenomenon wherein understanding the meaning of certain words and phrases in an utterance requires contextual information.





Literature for and against immune treatments….

23 01 2013

From Dr. Braverman’s blog:

Posted on: 12-Oct-2010 5:21am
Pts have called me and asked “why do other doctors quote literature that says immune treatments don’t work or are dangerous?”

The first thing everyone has to realize is that there is literature on both sides of the argument, in fact, most of the literature today supports the diagnosis and management of immune related causes of RPL (most of this is from journals around the world as not much research is done on this topic in the US). Most of the doctors who quote the literature against Immune-related rejection and treatment do not have any background in immunology and don’t have the ability to see the flaws in these studies. Most studies against the use of IVIG or even PLI [Paternal Leucocyte Immunization] were and are flawed by many factors. The most significant is the complete lack of understanding of the many cells lines involved in immune tolerance and hence immune rejection and simply treating anyone with RPL without knowing the reasons you are treating won’t give you any answers as to whether therapy works. Most of the recent literature is starting to address this issue and is looking at a complete immune cell analysis and drawing much better conclusions. Certainly there is no argument the immune system is involved in pregnancy loss, and that treatments help many patients avoid miscarriage and IVF failure (just look at our list of patients that have had so many losses, some as many as 18, before we treated them and you’ll understand that the treatments work.) Our job is to try and shorten the list of those that need to be treated so patients who don’t need the treatment don’t get it. But as a last option for so many patients you just can’t ignore the prescence of these treatments.

The second issue is that of PLI and the fact that it is not FDA approved due to a Lancet study in 1998. [I’m looking for the cite of the study.]  Again the world literature is already way beyond this conclusion and has showed the studies here were flawed by improper preparation of the PLI injections and loss through refrigeration of the very important receptors on the cells that were to be injected to help develop immune tolerance. But again the lack of understanding of immunology by those quoting these studies has guided many away from treatments that are now helping so many patients around the world.
Lastly is the safety of the treatments. There is abundant literature showing the safety of IVIG and large series have shown this treatment to be safe not only in pregnancy but in all other autoimmune syndromes that it has been used to treat. This is consistent with our history of no serious complications in all the years we have been treating patients.
The most important issue seems to be experience in seeing, diagnosing and treating this very complex group of patients. We rely on the great success we have had over the years as the best proof that our diagnosis and treatments are effective. It’s unfortunate that many have begun treating patients for immune related pregnancy loss with limited knowledge of the field and as we have stated on this site , these are best left in the hands of those with great experience as this still is the most important quality necessary for success.
I will gladly share the literature on these topics and any one should feel free to call me to discuss them. Our success is no coincidence, and misguided literature should not sway someone from at least exploring and understanding these issues and if they relate to their own problems with RPL. It would have been a shame if all the people we have treated over the years avoided looking into these issues.”
 
To contact Dr. Braverman, fill out the form on the right hand side of his page here.





Getting a little down.

22 01 2013

I have spent too much time on the Yahoo forum for reproductive immunology.  Some bad energy there right now from ladies who are dissatisfied with Dr Braverman, and even the hardcore supporters of his and of other doctors are making me sad (not their fault!) just because they’ve been trying SO LONG and yet to have a baby.  (Yes, there are lots of women with success stories and I need to stay positive, right?)  It just sometimes hits me that we only have 4 blasts on ice and will never make more (age, finances, and hubby resistance) so if I don’t make one of them work, I’m not going to be a mom.  It’s a daunting thing, to maintain hope while knowing some ladies have done >10 IVFs and still no baby!

GAH!

Sorry for being depressing today.

To make up for it… a brief report on that salmon recipe I posted recently.. I panfried the salmon after making the sauce.  Also, I didn’t have shallots, so I used an excessive amount of garlic.  I liked the sauce, it had a very subtle sweetness, not too tart (the red grapefruit I used was quite sweet on its own) and the cayenne gave a very delayed hit of heat that you didn’t notice till bite two or three.  I thought the sauce was fantastic over quinoa which I cooked with sauteed onions in chicken broth, and I even put the sauce over some sauteed green cabbage.  So all in all, a success.  Though I am still eating cabbage– it was on sale so I bought two heads, and boy, does that last a long time when your DH isn’t super keen on cabbage.  It’s high in vitamin C so I know it’s good for me, lots of fiber too… but not terribly satisfying for snacking.

Chicken Bean Tostadas : from FineCooking.com
— gluten free, serves 4

8 6-inch corn tortillas
1 Tbs. olive oil; more for the tortillas  (Or, use premade tostada shells and skip steps 1-2 below)
Kosher salt
Fat free refried beans– regular or black beans
Sour cream (optional)
1/2 medium yellow onion, chopped (1 cup)
1 tsp. cumin seeds
1/2 Tbs. minced canned chipotle chile (about half a medium chile)
1/4 cup lower-salt chicken broth
4 cups shredded leftover white meat chicken (about 2 breasts from rotisserie chicken)
Broccoli slaw (shredded broccoli stems, found bagged in vegetable section of grocery store)
Fresh pico de gallo or mango salsa
Crumbled queso cotija or feta cheese
Chicken Tostadas with Black Beans and Cilantro-Lime Cream recipe

  1. Position a rack in the center of the oven and heat the oven to 400°F.
  2. Lightly brush both sides of the tortillas with oil and arrange them in a single layer on two large heavy-duty baking sheets. Lightly season the tortillas with salt and bake, swapping and rotating the pans halfway through, until golden-brown and crisp, about 15 minutes.
  3. Heat the olive oil in a 3-quart saucepan over medium heat. Add the onion and cumin seeds and cook, stirring, until the onion is tender and golden-brown, about 8 minutes. Add the beans and chile and stir until heated through. Stir in chicken broth and bring to a simmer. Season to taste with salt.
  4. Microwave the chicken 1-2 min or until heated through.
  5. Arrange 2 tortillas on each of 4 large plates. Spread the bean mixture over the tortillas. Top with the chicken, and then brocco-slaw and salsa/pico. Spoon some sour cream over the tostadas if you’re not dairy free, sprinkle each with cheese again if not dairy free, and serve.

 

 





Humira update, a nice salmon recipe, etc…

17 01 2013

God bless, it’s been difficult to post here.  Don’t know if wordpress was down, my work firewall was blocking it, or what!!!

Humira– took the first shot last Wednesday so it’s been a week, and no side effects.  I am eagerly awaiting my second shot on the 23rd.  I have this gut feeling the first series of shots won’t do enough and I’ll have to do a second series… I’ve even asked Braverman if I can skip the testing and just do a second series to save the money.  No answer on that yet.

I’m back to gluten free and reduced dairy, and reduced sugar.  I’m about to start a new supplement for reducing tnf and cytokines, recommended by Dr. Braverman– called Align B Infantis probiotics.  He has a new PhD immunologist on his staff and says the research and results are amazing for this supplement.  I’m also back on my fish oil, A C E D vitamins, alpha lipoic acid, 200 mg of CoQ10, and I’m missing some that I can’t recall.  And I’m back in the gym and training jiu jitsu again, hoping to lose at least 15 lbs. 

Here’s a healthy, gluten free recipe… From FineCooking.com.  This delightfully different champagne-pink sauce has a tangy, sweet, and spicy balance that pairs perfectly with the rich salmon.  One of my new year’s resolutions is to eat fish at least once a week.  And I love salmon.  Serve it with rice or quinoa and maybe some steamed spinach or broccoli.  Serves 4.

 https://i1.wp.com/www.finecooking.com/CMS/uploadedImages/Images/Cooking/Articles/web_only/Krieger-Salmon-Grapefruit.jpg

4 skinless salmon fillets (5 to 6 oz. each)
1/4 tsp. salt, plus more to taste
2 ruby red grapefruits
2 tsp. olive oil
1 Tbs. minced shallot
1 tsp. peeled and grated fresh ginger
2-1/2 tsp. honey
Pinch of cayenne pepper
2 tsp. fresh lemon juice
2 Tbs. thinly sliced fresh basil

Preheat the oven to 350°F. Season the salmon with the salt, place in a baking dish, and roast until cooked to taste, about 10-18 minutes (depending how rare you like it, all the way to fully-cooked).
While the salmon is cooking, prepare the sauce. Cut one of the grapefruits into sections by cutting off the top and bottom of the fruit, then standing it on one end and cutting down the skin to remove the woolly white pith and peel. Then, with a paring knife, remove each segment of fruit from its membrane and cut the segments in half. Set the segments aside. Juice the other grapefruit and set the juice aside.
In a medium skillet, heat the oil over medium heat. Add the shallot and cook, stirring, until softened, about 2 minutes. Add the ginger, grapefruit juice, honey, and cayenne and bring to simmer. Cook until the sauce is reduced by about half, about 10 minutes. Add the lemon juice and season with salt. Right before serving, toss the grapefruit pieces and basil into the sauce.
Place the salmon on a serving dish, spoon the sauce over it, and serve.





Humira on its way!

8 01 2013

Stupid insurance wouldn’t cover it so I bought it from another source.  I am delighted to report it will be arriving tomorrow and I will be taking it tomorrow!  Onwards and forwards, hoping for a FET this spring!





Happy 2013, I hope.

3 01 2013

This will be another year of hope for me.. hope for (of course) a successful pregnancy and a healthy baby.

Hope you had a happy holiday… I enjoyed ours very much, on the east coast with family and friends, and too much good food 🙂  Starting Jan 1, I’m back on the gluten free, dairy free, and (new for me) sugar free thing.  I am still trying VERY hard to come up with some affordable humira to begin my preparation for the FET which might be as soon as this spring.  Two ladies emailed me, one with a very low price, and she hasn’t emailed me back after our first 3-4 exchanges.  Murphy’s law!  But I’m hopeful she’ll get back to me soon and if not, I will pay the higher price just to be able to get started.

A dear friend who is in her 40s, with two children, had been trying and trying to get pregnant naturally…. she succeeded, which surprised her, about 3 months ago.  However, her anatomy scan came back with bad news, and the CVS/FISH confirmed that her baby has Down’s.  She will be terminating next week.  I know this is a touchy subject for many, but I am supporting her fully and with love.  And hoping that this won’t be MY situation.

Sending you love and hope for your 2013…

G








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