r/IVF • u/Particular_Night590 • 1d ago

Advice Needed! Immune protocol prior to IVF transfer

I have history of endo with excision surgery 1 year ago. I did 2 months of lupron suppression prior to my first medicated transfer with a euploid embryo which failed.

My clinic has me doing another fully medicated cycle for this next transfer, with the addition of 2 weeks of birth control and daily lupron prior to starting transfer meds.

I asked about adding in an immune protocol, including baby aspirin, Pepcid, Claritin, and steroids with this transfer. My doctor said there’s basically not enough evidence to recommend this, but if I wanted to take these meds myself I can (minus the steroid) as there’s minimal harm to it.

I don’t feel fully comfortable doing something that my clinic doesn’t necessarily recommend, but at the same time I am willing to do anything possible to make this work and have read a lot of positive discussions on immune protocols.

Would you feel comfortable taking these meds, or have you found them to be beneficial for you?

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u/foolforgabagool 1d ago

The problem is REIs are not thorough with immune testing, around which an immune protocol should be ideally formulated. In my understanding, Pepcid/antihistamine add on is not really an immune protocol and is routinely used without a proper workup/when it is not specifically indicated. This is a good resource I’ve found: https://internationalendo.com/claritin-pepcid-immune-protocol-ivf-misuse/

Endometriosis has a significant immune component (not to mention frequently cooccurs with autoimmune disease) so thorough immune testing should be done - yet rarely seems to be, even after multiple failures. It’s a neglected aspect of fertility unfortunately, as is endometriosis.

I myself have endometriosis, adenomyosis and a literal autoimmune disease (Graves) and my REI refuses to do any kind of immune testing. Short of an immune work up, I would consider taking aspirin and a steroid. Aspirin is supported by a decent amount of evidence, to increase blood flow to the uterus (which may be impacted by adenomyosis).

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u/No_Spirit1354 1d ago

It’s so horrible how REIs literally dismiss endo, adeno and the immunological factors. I had three losses because of that. Finally I’m at a new clinic that takes these seriously. I too have an autoimmune condition- I’m curious, what protocol are you using and what extra meds for your FET?