Hello! I’m so grateful to come across this generous offering to answer questions 🙂

I am 36 years old and currently 5W, 2D (gestational sac measures 5W, 5D). Natural pregnancy, B-HCG numbers strongly doubling. I have an RE in Chicago and see a Reproductive Immunologist as well. I am currently on 20mg prednisone, 40 Lovenox twice/day, baby aspirin, PIO, Metformin, and other supplements.

My history is two losses (natural pregnancies) at 6W 3D and 6W 4D; heartbeat both times, but nothing by 7 weeks. We did not test the first loss, but tested the second with chromosomally normal results. After the second loss, my OBGYN did a full RPL workup and I tested positive for Lupus Anticoagulant (blood was drawn when still carrying the missed miscarriage). Further testing showed I had retained tissue (not sure if from first or second loss, and if it was from first, could that have effected second pregnancy). With RI, I tested positive for PAI-1 gene and elevated PAI-1 level; NK 50:1 blood test result was 24.4.

My bloodwork with positive pregnancy shows NK controlled at 20.4; CD56 at 4.6; homocysteine at 5.4; cytokines normal, all bloodwork is looking good. However, the concern is in approaching the 6 week mark as my losses were at the same time. My understanding is just because my immune response is okay now, it could surge at any time.

IVIG has been recommended by my RI, but not my RE. My RI does not endorse Intralipids. My question is, could the current protocol of 20mg prednisone and Lovenox shots be enough for a successful pregnancy? Or is 20.4 NK too high?

My sincere and humble thanks!