For my FET on 3/16, what to do with PAI-1? (x-post)March 10 2011 at 5:24 PM
|Bear (Login Bear9)|
Well, almost exactly a year after the fresh cycle, my body is finally allowing me to do a FET. My cysts are disappearing and not producing hormones, and my lining checked out.
Working with the Beer Center years ago, I found out that I have MTHFR, Factor XIII and PAI-1 ("blood-clotting") gene mutations, in addition to anti-cardiolipin antibodies (blood clotting), and the antithyroid antibodies that I already knew about. My cocktail is aspirin and Lovenox (am switching from Arixtra) for the clotting issues, IVIG and Dexamethasone for the thyroid antibodies. My regular Endocrinologist suggested Metformin, "just in case."
Lately, I have looked into the PAI-1 (plasminogen activator inhibitor) issue, and I really think that it is a big problem for me. High levels of PAI-1 interfere with the release of the egg during ovulation (ding-ding-ding, it seems that often my body shows all the signs of ovulation, but then doesn't release the egg and forms a cyst instead), the ability of the corpus luteum to produce progesterone (I have always low levels of progesterone) and interferes with the process of implantation (clearly, that has not been happening).
Anyway, I am not going to do the IVIG this cycle, but my question is, do I take the Dexamethasone steroid? Steroids increase levels of PAI-1, which is the last thing I need. Yet, I have Hashimoto's autoimmune disease, which is why my dr. prescribed them, to quiet my immune system, to keep it from attacking the embryos. The steroids have never gotten me pg though, and I wonder if it is because my PAI-1 goes up. My gut is to skip the Dex this (maybe my last) cycle, and focus on keeping the PAI-1 levels in check with Metformin, Lovenox and ba. Yet I doubt myself, and then think that I should start the steroids today for the like the doctor ordered, maybe the Metformin will help enough to keep the level down, and the steroid would suppress the antibodies. I don't think the doctor is paying attention to the PAI-1, and just thinking about Hashi's. Any advice?
I'm sorry this is so long, I couldn't figure out how to make it shorter!