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Results From Dr. Kwak-Kim

After waiting patiently for the phone call and having to reschedule it, I was able to talk with Dr.Kwak-Kim regarding my results. I was hoping to get some real answers or to have a clear path to follow, but that didn’t happen.

No major breakthroughs were found as to why my pregnancies don’t last. A large part of me was hoping that something would be discovered as to why this keeps happening, but it wasn’t. A few blood panels came back with elevated levels and they could be contributing to my losses, but we really aren’t sure. It just seems that my body has a few minor things that aren’t working as they should be.

I feel more overwhelmed than ever and am starting to question if carrying a pregnancy to term is for me.

So…..after taking about 30 vials of blood, here are the things that came back abnormal or elevated.

Test Results

TSH is 3.14 (Higher than it has been in a while)

ATA (Hashimoto’s) negative

MTHFR(C677T)  gene heterozygous mutated

TH1/TH2 Cytokine: Increased T-helper 1, Inflammatory immune responses. Domminance of TH-1 Cells cytotoxic & pro-inflammatory.

Natural Killer Cell slightly elevated

AMH dropped to 1.72

Polycystic Ovaries – Mild PCOS

The recommendation

Before a conception cycle Dr. Kwak-Kim would like me to do the following:

Start Metanx once daily for MTHFR ( because I have a heterozygous mutation extra folic acid is recommended)

Start Metformin ( to help with PCOS and imbalances in my glucose levels)

Increase thyroid medication

Take one baby aspirin daily

Take prednisone 10 mg, once daily before BFP and twice daily after

Start lovenox 40 mg once daily before BPF and twice daily after BFP

Uterine Biophysical profile 5-7 days post lovenox treatment

Start Promethium

Start Immune Globulin (IVIG), every 2-3 weeks.

Once BFP comes along:

APTT, Chemistry panel and a CBC with platelet count eery month while on lovenox.

TSH, Free T-4 and Free T-3 weekly

Antiphosopholipid antibody, anti-DNA/histone antibody, ANA, NK assay, PAI-1 and TH1/TH2 cytokine testing starting with BFP

Beta draws every 2 days until heartbeat is detected

Blood pressure monitoring weekly while on Lovenox

Ultrasound using gray-scale and Doppler techniques to assess the pregnancy development should be done every week beginning at 5-6 weeks of gestation through the first trimester then monthly.

At 28-30 weeks, weekly non stress tests and biophysical profile exams should be done

WHAT TO DO

Basically I want to cry.

The amount of tests, results, blood draws, and appointments that I have to pay attention to once I get pregnant is overwhelming. Gone are the days of getting a BFP and rejoicing. Instead when I finally get another BFP I will be put into survival mode trying to remember every injection, vitamin, and pill that has to be taken at certain times.Trying to help the baby survive and thrive in my hostile body.

The other day my hubby had told me that when we do get pregnant again he doesn’t want to do any ultrasounds or think about being pregnant until 8 weeks…poor guy obviously hasn’t looked over the report from Dr. Kwak-Kim. But, that just goes to show that we are both afraid of going through another pregnancy. Both afraid that we can’t handle another loss.

So, what am I going to do? Dr. Kwak-Kim says it is up to us if we want to undergo another round of IVF, but that she doesn’t believe we need it. According to her we can get pregnant, and if our issue was purely chromosomal then we would have had a healthy baby by now. That it is very odd to have 6 irreguarlities with chromosomes in a row. And, for once I agree with a doctor.

The hubby and I have discussed it and we are going to put IVF take 2 on hold to try naturally. Part of me is excited to not undergo another round of IVF and to see what my body can do on it’s own. But, another part is terrified to go through months of trying and then waiting for a BFP and then waiting for an ultrasound. WHy is the waiting part so killer? There really isn’t a winning situation when it comes to my decision and we just have to go with what we feel comfortable doing.

The one thing I have decided to go against is the doctors recommendation for IVIG. I’m just not there yet. I know it has worked for some women, but I can’t bring myself to make that decision. I am ok going forward with all of her recommendations, minus the IVIG. I’ve thought long and hard about it and decided its just not right for me. I am willing to follow every other recomendation and to do what she says, but I just don’t see how it would help me.

So there it is in a nutshell, the recomendations from Dr. Kwak-Kim.

Xo

26 thoughts on “Results From Dr. Kwak-Kim

  1. Sometimes all the uncertainty- the not knowing- can be the hardest part. You are right to feel so overwhelmed at all this information! Still, there is still much reason to hope. ❤

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  2. It is overwhelming. I’m on a borderline protocol and it feels like I have a lot to do. And I can really relate to wanting just to forget about treatment for a bit! I’m just hoping it is worthwhile. Hope that you can get your head around it. X

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  3. Oy vey, that’s a lot to think about. Sending mega strength your way and lots of meditative breathing 🙂

    I’ve been reading a lot about the IVIG and most of what I’m reading is that intralipid therapy is not only cheaper but showing greater success (there’s a link to the study at the end of this blog: http://www.bubblesandbumps.com/natural-killer-cells-is-my-uterus-a-war-zone/). If our NK looks high when our results come back in, I’m asking for intralipid and prednisone.

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  4. That’s so full on, I agree it is completely unfair that seeing a positive will now be changed forever. I wish that there was only excitement in that moment for you. I really hope this works for you and can understand how overwhelming it all is and how depleted you must feel. Xxx

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  5. I’m sorry to read that you are so overwhelmed. It’s so hard to juggle remembering what pills to take when, and how many, and on empty stomachs, without eating XYZ too closely to the pill. I will be praying for you and your husband during this time. I hope your husband can be the support you need to make decisions as you move forward.

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  6. Eventhough the results are not what you expected, atleast you get a protocol to work with!. Ivig is really investigational and i respect your decision not to take it now. If the nk cells are slightly elevated, prednisone is enough(atleast based on my experience). Good that you are planning to try naturally without ivf. The protocol is already overwelming and i would say ivf makes it hard😒. Just relax friend! You have been through a lot already! Even we decided not to do uktrasounds till 8th week, but dr kk insisted us to do usg from 5 week which turned out really good for us. We have an sch in uterus which was found on 5th week scan and she adjusted meds and injection dose based on that. Due to that my sch is stable now. Good luck!!👍

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    1. Thanks for you support, it means a lot. I just feel like everything else is already so overwhelming without adding IVIG to the mix, but it wasn’t an easy decision as I don’t want to look back and regret anything. But, I feel like with my results and everything else that she has prescribed that it’s enough. I can’t imagine adding IVF into the mix, you are one tough lady to do that. I am happy to hear that having ultrasounds at an early stage are beneficial as I wasn’t looking forward to that, but I am so happy it helped you. Glad that things are progressing well for you. xo

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      1. Sure thing!!. Wishing all the very best for you! Dr KK suggested us not to do ivf with this protocol as we never had any issue in getting pregnant. Way to go girl. I am so thrilled that you are lookibg forward to this protocol..for me, the poor blood flow was an issue and after taking lovenox, it improved a lot!.. Lovenox seems to be tough first, but it is quite easy. Our last ultrasound with RE is on next tuesday (9.5 weeks), and if everything goes well, i will be graduating to my obgyn from the week after that. Fingers crossed!!!

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  7. Wow what an incredible amount of information to digest. I wish you the best of luck with trying naturally and I hope it happens quickly to take some of the waiting out of it. I also think you are making the right decisions for you and your husband and that’s what matters. Good luck and I sincerely hope that this helps!

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    1. IVIG is an infusion that aids in minimizing the actions of the NK cells (natural killer cells). IVIG stands for Intravenous immunoglobulin and it is a sterile, highly purified immunoglobulin G (IgG) derived from large pools of human plasma. Not all doctors recommend it as there are still studies being done on it, but Dr.K-K believes in it. I’m still not sure if it’s something I would want to do. xo

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