Prednisolone advice please

[MrsE]

Hi Dr Braverman

I would be really grateful for your opinion please.

I am quite an allergic person - I have the annoying but common combination of asthma, eczema and hayfever. This summer my asthma was particularly bad - I was taking over 20 puffs a day of various inhalers and needed a nebuliser every couple of weeks.

I had a FET in August but around 30 hours after transfer I had what I thought was an immune response - all of a sudden I felt incredibly sick and faint and I started shaking like I had the flu. My teeth were chattering in 28 degree heat! After around 4 hours tucked up in bed it passed but needless to say I had a negative beta 10 days later.

My next FET is scheduled for 18 November. This time my clinic have agreed to intralipids before, at and after transfer and 40mg clexane from the start of progesterone. They've also scheduled 10mg of prednisolone starting at the same time as progesterone but this dose seems low - I have 40mg each day for 5 days when my asthma flares. Having said that my asthma has now calmed down to its normal level (although it can flare up again with hormones - my worst ever asthma has been from 6 months pregnant onwards).

Do you think I should take a higher dose? Should I start the prednisolone earlier? I know it's incredibly hard to say when you have no test results but I'd be very grateful for your opinion. I don't want to over suppress by immune system but this is my last embryo and I'm frightened of the same thing happening.

Thanks in advance.


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[Dr. Braverman]

Hi Dr Braverman

I would be really grateful for your opinion please.

I am quite an allergic person - I have the annoying but common combination of asthma, eczema and hayfever. This summer my asthma was particularly bad - I was taking over 20 puffs a day of various inhalers and needed a nebuliser every couple of weeks.

I had a FET in August but around 30 hours after transfer I had what I thought was an immune response - all of a sudden I felt incredibly sick and faint and I started shaking like I had the flu. My teeth were chattering in 28 degree heat! After around 4 hours tucked up in bed it passed but needless to say I had a negative beta 10 days later.

My next FET is scheduled for 18 November. This time my clinic have agreed to intralipids before, at and after transfer and 40mg clexane from the start of progesterone. They've also scheduled 10mg of prednisolone starting at the same time as progesterone but this dose seems low - I have 40mg each day for 5 days when my asthma flares. Having said that my asthma has now calmed down to its normal level (although it can flare up again with hormones - my worst ever asthma has been from 6 months pregnant onwards).

Do you think I should take a higher dose? Should I start the prednisolone earlier? I know it's incredibly hard to say when you have no test results but I'd be very grateful for your opinion. I don't want to over suppress by immune system but this is my last embryo and I'm frightened of the same thing happening.

Thanks in advance.


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I think you should have a complete immune profile so you dont have to guess what your therapy should be. Putting embryos in should not be a hit or miss with therapies option. I would be happy to guide you.

[MrsE]

I think you should have a complete immune profile so you dont have to guess what your therapy should be. Putting embryos in should not be a hit or miss with therapies option. I would be happy to guide you.

Thanks for coming back to me so quickly Dr Braverman. In an ideal world I would prefer to have an immune profile and I appreciate your offer of guidance. Sadly for this cycle we don't have the time or resources available, especially as I'm based in the U.K. I'd be happy to consult with you if we do another cycle but if in the meantime you have any thoughts on the meds that have been suggested to me I'd be very grateful (but I will understand if not).


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[Dr. Braverman]

Thanks for coming back to me so quickly Dr Braverman. In an ideal world I would prefer to have an immune profile and I appreciate your offer of guidance. Sadly for this cycle we don't have the time or resources available, especially as I'm based in the U.K. I'd be happy to consult with you if we do another cycle but if in the meantime you have any thoughts on the meds that have been suggested to me I'd be very grateful (but I will understand if not).


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Its not that I wouldnt want to make a recommendation , without a proper workup I have no basis for any recommendation , Im sorry. :(