August 31, 2006

Better Fertility Through Fat

Our first frozen embryo cycle is officially underway. Lupron? Check. Delestrogen? Check. Ultrasound appointments scheduled, plane tickets reserved, infusion of fat cells planned? Check, check, and check.

Yep, fat cells. And I’m not talking collagen to add extra pout to my lips, which, believe me, are pouting plenty on their own over this latest development.

Doc wanted me to repeat a few tests before we do the FET. He doesn’t have all of the results yet, but the NK (natural killer) cells results came back today. I had done that test and several others at a local lab during The Bloodletting of 2005. The NK results were normal that time, but Doc wanted me to repeat a few of them through a lab he uses. This time, my NK level came back at 13.9 percent, with anything over 10 percent considered elevated.

I haven’t done a lot of homework on NK cells yet, but my rudimentary understanding is that if they’re elevated, it can mean that they’re attacking the embryo and the developing placenta instead of recognizing them as things that are okay to be growing in the uterus.

REs who believe in immune issues often use a blood product called IVIg to treat women who have elevated NK cell levels. Doc is among those who prescribe IVIg, but he and one of his colleagues have also recently begun using something called intralipids in place of IVIg. It’s hundreds of dollars per IV infusion rather than thousands, it only takes an hour as opposed to three or four hours, and it’s not a human product, so it doesn’t pose a risk of disease transmission. There isn’t a lot of data on intralipids as a treatment for NK cells in infertility yet, because it isn’t widely used for that purpose at this time, but Doc says success rates are proving to be about the same with IVIg.

The intralipids infusion involves an IV bag full of a milky white solution that includes 20 percent fat cells (from soybean oil I believe), hence the “lipids” part of “intralipids.” I asked if I couldn’t just eat a couple extra bags of potato chips instead, but no such luck. The infusion is scheduled for mid-September, about a week before transfer.

Like most of you, there are things I never thought I would have to do, such as give myself shots or go through IVF. But allowing myself to be injected with fat cells?!? That is so far beyond “things I never thought I would have to do” that I’m at a loss for words in some respects.

I do, however, still have the ability to form at least a couple of thoughts:

1) Boy, are the future kiddos ever going to owe me for this! Forget the “do you know how many hours of labor I had to go through for you??” guilt trip – they’ll have to sit through my “do you know how many fat cells I had to have injected for you??” tale of woe. (I’m joking, I’m joking. Mostly, anyway.)

2) Since I have to suck it up and have this infusion, I think it would only be fair if I could at least direct the fat cells as to where they’re allowed to take up residence: “The cells on my hips and thighs already have plenty of company, thank you, so can you please make your way to…well, never mind that, there are very few slender places on my body to begin with, and I’d really prefer that you not make any of those places bigger, either.”

“So once you’ve done your duty by binding to the NK cells and neutralizing them, can you please just make a speedy exit out of my body? Because, let’s be honest here, even I know my threats to exercise you away will only incite mirth and not instill fear. And I certainly don’t need any more of you jiggling around on me while you’re laughing.”

So there you have it, the latest weapon in the infertility fight: bags of fat. Is it just me, or is all of this starting to sound a little bit insane??

17 comments:

Thalia said...

Umm, yes, a little insane. Colour me a total non-believer in this NK thing anyway. It was the article I read which pointed out that the concentration of NK cells in the peritoneum (and womb) bears no relationship to that in the peripheral blood system that did it for me. And I quote:
"It's like measuring the density of black taxi cabs on the M25 and extrapolating to how many red buses there are in central London".

But you know, if it can't do any harm, and it makes you feel more confident, then by all means go for it!

the waiting line said...

Jeeze, that does sound nuts. The things we do to make this crap work. . . .

Good luck!!

Meg said...

It does indeed sound very very strange... but i guess, anything they may have in the bag to make it work, right?

Good luck, Rebecca.

Liz said...

I'm one for trying something new, especially if it will help with the cycle. Wishing you the best.

Lara said...

Crazy man...just crazy! But then I would be willing to stand on my head naked in public and sing michael jackson songs if that meant I'd get pregnant! So go for it!

Nico said...

I'm glad you still have your sense of humor about this! I enjoyed your hypothetical conversations with your kids, and I really hope that you do get to have that conversation in about ten months :-)

Shazz said...

Wishing you good luck!!

fisher queen said...

Good Lord, what else?

Nico said...

How are you doing? I hope things with the cycle are going well...

sube said...

And I thought I'd heard it all. Crazy!

(And how did I miss this post? I must be living in a cave ... either that or my trusty RSS reader is letting my down. Anyway, hope you're doing well. You must have started your cycle by now, yes?)

Anonymous said...

I too had intralipids and IVIg - when I read the consent form I stopped in mid read to ask the nurse "so this is going to add MORE FAT to my body? Am I going to walk out of here 10 lbs heavier?" LOL

Anonymous said...

Just read your blog, I just found out I will need intralipids too, are you going to SIRM by any chance?

Anonymous said...

I have a 2 and a half year old son and have had three chemical pregnancies since. I've had the full RE evaluation and nothing was found wrong. I finally tested for NK cells and was 17.9%. However, I can't find a doctor knowledgeable in intralipid treatment within an hour of my home (Fairfield, CT). Any advice?

Rebecca said...

To the last Anonymous poster - I don't know if NYC is more than an hour from where you are or not, but SIRM is the only place I know of that is doing intralipids. Back when I did it, only SIRM - LA was offering it, but I believe a few months ago all SIRMs switched from IvIG to intralipids after reviewing study results.

Chris & Mildred Gallegos said...

I have been pregnant many times all ending in a loss. I am currently 7 weeks pregnant and though my nk's are borderline, my cytokines are still very high (49) despite having had IVIG 2 weeks ago. I am going in for an infusion of intralipids tomorrow (first time) at my local hospital at the suggestion of my OBGYN. I am hoping and praying that lipids prove to be more effective in suppresing my immune numbers then IVIG.

Anonymous said...

I am a patient at SIRm and also having the NK test done. i hope that it's neg. but if not I'll be doing the intralipd in Sept. too.
I was curious about the fat being injected. God i hope it doesn't just stick in you and add a ton of extra calories.

Cathy said...

After a failed IVF with transfer of a "perfect" blast, I'm looking into some of this immune stuff before starting doing an FET with any of our remaining 7 blasts. I've had two chemical pregnancies and just feel like my immune system is FUBAR. good luck to you.