Thursday, February 28, 2013

The more reading I do...

The worse it gets...UGH...This HLA/DQ match stuff sucks...

I am still just baffled that we are even having to deal with this!? It just seems so crazy to me! What are the chances!?...I always seem to be apart of that "less than 1% of 1%" group that the stupidest crap happens to! UGH....

I am trying to keep the faith and know that I believe in a God who can do amazing miracles, but at the same time, I also have to be wise, and let my body and mind rest a bit...I have been through so very much...

I have decided to go on a couple cycles of birth control, to let my system "rest" a bit so to speak, while we figure out a game plan with the new DR, and figure out if insurance will cover the treatments. (please God, please!)...The two meds we would need are either Neupogen, or IVIG- both of which are VERY, VERY expensive, and are VERY hard to get covered by insurance...:sigh:

This is all just so much to take in...Passing the 2 year mark, with NO baby, NO BFP, and now, not even the CHANCE at another baby for a while...It hurts soooo, sooo much .... I hate, hate, hate this...I keep trying to focus on other things so I don't get down in the dumps, but no matter what I do, I just keep coming back to all of this bad news, and I just can't help but cry...

I do know, that I will make it through this, and I will be stronger because of it...I wont let this break me...I believe, that some how, some way, we will be blessed with a miracle...I don't know what that is going to look like, but I know it in my heart....Lord just give me peace, and strength until then....

Try again...

Came across this beautiful song, written by a beautiful young woman named Miranda Dodson, about her own losses....It is called TRY AGAIN...

Check it out...

Click here

Tuesday, February 26, 2013

Feeling a bit down...

OK....actually, really down....

I got hubby's DQAlpha/HLA results today....And we have quite a few "matches"... and I have some "not so great" characteristics about mine that make me even more apt to having implant failure and losses....This, combined with the higher NK cells, low T regs and Hashi's/PCOS issues, gives us answers, as to why we have had so many losses ...But this also means we will NEED treatment to have a take home baby, and the treatment is NOT cheap...( anywhere from 2000-5000 bucks a month for up to 3 months possibly  more depending on how many cycles it takes to fall preg)

Here is some info about the HLA/alloimmune issues...From the SIRM website.

Alloimmune Implantation Dysfunction – This is the most common immunologic cause of recurrent miscarriages. here is how it works: With fertilization, the sperm contributes genetic material to the fertilized egg or embryo. That is why an implanting embryo, is in about 90% of cases immunogenetically different from the mother’s genotype…Yet, in spite of this difference the embryo is accepted and allowed to continue to develop into a viable pregnancy. This so called “paradox of pregnancy” is due to magnificent immunologic adaptations in the uterus, brought about by interaction (“communication) between an immunologically distinct embryo and the predominating immune lymphocytes in the uterine lining known as natural killer (NK) cells. Sometimes (in <10% of cases) the embryo and the mother might share certain similarities involving genes known as DQalpha and HLA. When this happens, after repeated exposures of the uterus to consecutive matching pregnancies, uterine NK cells (as well as and other immune cells known as cytotoxic lymphocytes) begin to release excessive amounts of cytotoxic cytokines that attack the embryo’s trophoblast (root system) , thereby initiating a rejection process that often precipitates a first trimester miscarriage.Such alloimmune implantation dysfunction is thus a relatively common immunologic cause of recurrent first trimester miscarriages , making testing for alloimmune similarities in both partners an important part of the evaluation of non-chromosomal recurrent pregnancy loss. This requires comparing the mother’s and father’s HLA and DQ alpha genetic status for “matching similarities”.When the sperm provider and the embryo recipient share one or both DQ alpha genes and/or have several other HLA genes in common, implantation failure can occur, usually manifesting as early RPL (and sometimes, albeit less common, as “unexplained” infertility or IVF failure). However, for such alloimmune matching to lead to implantation dysfunction (e.g. miscarriage) there must be associated activation of uterine NK cells (*and mine are activated*) (NKa) as evidenced by the K-562 Target cell test and/or increased endometrial TH-1 cytokine activity determined through sampling. In the absence of such NKa, even the severest form of alloimmune matching will not prevent a perfectly normal pregnancy from occurring.

I am just at a loss....I never would have thought we would have "matches" like this, because we have the two other babies together, which apparently are miracles....But I guess the more pregnancies/losses you have the worse it gets...Each time it activates the NK cells further...No good!

I am still going to see the DR in NYC and see what he says and what his "game plan" would be...But, There is a really good chance, (98% chance) we may have to set aside TTC, go on birth control for a year or so, while we save for the treatments, and work on losing weight etc....

I do NOT want to have to do that....I realllllyyyy don't....I want my take home baby NOW....NOT 2 years from now...Or maybe never?...I want things be easy again..

I have not even tested again today (this morning's fist morning urine test was a light positive+) because I am just so broken about this...It basically means with NO treatments (which we did none this month) we are doomed to have another loss...I know miracles can happen, I have a couple of them sitting at the kitchen table right now, BUT, I have been praying for another miracle for 2 years... And after 15+ losses later, and still NO take home baby....I am having a hard time staying positive in light of this new info...

It IS nice to have the answers finally, and really KNOW why we have had all the losses, instead of being told it was just "bad luck" ( MY ass!! ugh!!). BUT it does not make it any easier to walk through right now...And it does not make me fee any better...In fact it almost makes me feel worse, because the treatments are so expensive and I know we cannot afford it for at least one year...Or more...Maybe never? I don;t know...I just know, I never thought I would be the "one" who walked away with no baby...After 2 years TTC....I Just never imagined it would be Me....

Ah, why can't I just get pregnant like the welfare  crack head baby mamma's....

Monday, February 25, 2013

still there....

Lines are still there...Maybe even a tad darker today...We will see what the next few days brings....

Here is second morning urine test...

and one I did at Noon...

Sunday, February 24, 2013

I realllllyyyy hope...

This is not the trigger screwing with me...

Messing with me...UGH....

Trigger is messing with me...Ugh the things I do to myself...LOL...( click on pics to enlarge them)

Here is the bottom test from the pic above ( 9dpt, 1pm ..the top pic show below) compared with one I just took at 3 pm ( bottom test)

edited to add a pic of the last two tests compared now that they are dry...

So nice.

My chart looks so freaking pretty this month, but I am afraid it is all just another big joke on me...I am not really feeling all that positive this month, and I am sure the progesterone is just making my chart look nice, but AF is lurking around the bend...=/

Trigger is barellllllyyyyy hanging on, but I still see a little hint ( 9 days past trigger today and 8 dpo) of a line, and I just wish it would go away!

Anyway, here is the pretty fake out chart....

I post back later with some test progression pics of the trigger...

Friday, February 22, 2013

I got some of them!!

I got some of the results from reprosource for my immune testing!! Of course, I do not know what hardly any of it really means in the big picture...I am waiting on some of my immune infertility guru's to look over the results and give me their educated opinion...Of course, Braverman will be the one that makes all the decisions as far as how to proceed with treatments, and what will be needed if anything, but I am just happy to have a few of the results on hand...I took some pics of the results, instead of trying to copy/type them back out and have it make sense...LOL...

I will post back in a bit when I get some feed back and do some research on the results...

OK, some basics, from what I can gather...

HLA means nothing right now, till I see DH's to compare...hopefully I can get those results next week...I am praying we have NO matches!

NK cell activity looks a little high.... could be a bit lower honestly... each RI's personal opinion on how how it should be based on % varies, based on the other blood test results...

 Good news, I don't have SLE (lupus) or other autoimmune diseases like scleroderma, Sjogren's, rheumatoid arthritis etc that are showing on labs....(another BIG yay!)

My TPO- Thyroid antibodies are positive, which I figured, with the Hashi's like flare I had last summer...My TPO were neg 3+ years ago though, so I am guessing with the onset of Hashi's also came the other immune crap that is causing the losses.

My T helper's are high-

My b cells are high-

My T-regs are low- Not sure what that even means...Here is a clip from Braverman's site about it..."

How Failure of Regulatory T Cell Functioning Causes Miscarriage

One of the ways in which immune tolerance is generated for an embryo is by the production of a special white blood cell called a regulatory T cell - also known as a T Regulator Cell (Treg). These begin to increase in number during the second half of the menstrual cycle in preparation for an expected pregnancy. Sperm entering the body also plays a part in the further development of these cells. The regulatory T cells go to the uterine lining and start to deactivate cells that would normally attack an invading embryo. They deactivate cells that would attack directly as well as those that would produce chemicals which cause inflammation and thus invite other immune cells to attack the area. Another issue they address it that of cells which "report" a foreign presence and thus cause the production of more cells to attack that tissue.
In these ways, regulatory T cells prevent the immune system from causing a rejection of the embryo. These cells also support these efforts by releasing chemicals that induce the formation of more regulatory T cells to assist with these protective measures. They also release an anti-inflammatory chemical to prevent inflammation from prompting an attack by the immune system. This same chemical also leads to the production of protective antibodies by the mother's B cells that further shield the embryo from the mother's immune system. As the body is designed to support pregnancies, it is when these mechanisms are not functioning correctly that multiple miscarriages can result."
And, I found some stuff on DR Beer's site- (here)

Lots more in here that I dint really understand....I am anxious to see what Braverman has to say!


Ugh...The dreadful part of the TWW....I always hate, hate, hate the days between 6 and 10 dpo...=/

The lines were suuuupppperrr light on the wondfo strips, and and the OSOM was a smidge lighter again...I wish the trigger would just go away already! LOL.
Chart is looking good though....Still, not really feeling all that hopeful...Just hoping for a miracle....

Here is my chart, and a test pic progression...

Thursday, February 21, 2013

30 days!

In exactly 30 days, I will be on my way home from my appt in Long island, with Braverman!! Eeeekkk!! I cannot believe how fast is is going! I am so excited to finally get in there and get some answers. I am going to call next week and just touch bases with the financial dept, to be 100% doubly sure I will only need to pay a co pay for the visit....Fingers crossed nothing has changed since the last time I called in about it....

Other than that, Just hanging out, waiting....Wishing it was 12 dpo right about now, instead of 5 dpo...=/

Here is today's tests....I know I said I was going to do every other day, but now my POASoholicness is getting the best of me..LOL...

Wednesday, February 20, 2013

5 days past trigger-

I am 5 days past trigger and around 3-4 dpo. Not really noticing too much in the way of symptoms...One BIG difference, if I have major constipation, and last cycle it was not like this. I also noticed LESS cramping, and MORE bloating. It is probably just the way the trigger effects my body when I do it intramuscularly  instead of SQ...Anyway...Without further ado, here is my tests. Wondfo and OSOM taken with the same sample.

Here is the dried progression

Monday, February 18, 2013

OSOM vs. Wondfo's

Just thought I would share with you all a comparison of Wondfo Vs. OSOM tests.

I did my test this afternoon, to test out my trigger, and decided to dip a wondfo at the same time so I could see the difference in lines.

Here is the pic! You can clearly see OSOM is more sensitive and easier to see/read! I am sooo glad I ordered the OSOM's this time!

And just "because", here is a pic of the dried OSOM tests progression from the last 3 days of testing out my trigger.

Sunday, February 17, 2013


Over the last two years, I have not ONCE thought about baby names, or nurseries etc...I just have not been able to bring myself to even day dream about it or buy baby stuff (with the exception of two outfits I bought the month before my surgery) etc....

I always have waited in the past, till the pregnancy was well established before  I started narrowing down names and thinking themes for the nursery and buying gear...especially THIS go around, when it seems like  whatever can go wrong, HAS already....Anyway....

Today, I have been thinking about our much hoped and prayed for (future) baby, and praying for some confirmation to keep me kind of hanging on till we see our promise come to fruition....I kept being brought back to 3 years ago, when we first started our journey to a reversal for another baby, (and to help with physical issues from my ligation, which have been gone since the reversal) and all the things that had to happen to even make it possible to have the money and even the time for the surgery, and so many other issues we had to over come time and time again, Just for us to be able to have a shot at "trying again"....And yet, all the obstacles we faced, we overcame each one...

I began to meditate on the all the POSITIVE things  that I have happened in our journey, the things I have learned about myself and the the people I have met ... Then, I was brought back to a time, right before we got the money for the reversal, (2010) when it seemed like all was lost for even being able to afford the surgery ( car repairs and crazy medical bills)...It was THEN, (confirmed through a couple friends at a revival service in May 2010)  I felt like the Lord gave me a name for our soon to be baby blessing that DH had been praying for for even though we had NO way to even try for a baby yet. (reversal was not done yet).

The name is Josiah...

One of my fave names I used to have growing up, for my "future babies" when I would day dream as a kid...I knew, then and there, we would be blessed with another baby boy, I just did not know when...

So up until today, I had never REALLY looked into the name, and what it means, because, well, we have not been pregnant long enough this go around to even consider names at all...But any time names come up, I go research crazy....It something I HAVE to do before it is even an "option" on the table as a name...I like to know what they mean before I name my Anyway, I digress....

So, this afternoon, I am just sitting there looking through baby names, and kind of allowing myself to savor the non jaded moment and day dream about our future baby,  and I kept hearing Josiah in my head again...After all, The Lord has brought us THIS far, why not believe for the full miracle....

So, I got thinking, and kind of hoping.... I did a quick Google search for what the name means just to see....I was blown away...

"The name Josiah is a baby boy name. The name Josiah comes from the Hebrew origin. In Hebrew The meaning of the name Josiah is: Jehovah has healed."

I instantly had my heart skip a beat when I saw the part that said..."Jehovah has healed"...I am believing I am healed, from all this crap in my body, and we will bring home our take home baby boy soon...I think of all we have endured and have overcome, and I am confident we will make it through this with a baby in our arms on the other side of it all....

The pain that you've been feeling, is just the the dark, before the morning...

Saturday, February 16, 2013

Alright, here we go!

On to the more "fun" part of the cycle!

I got my + OPK last night, and triggered before bed! DH and I have had a great BD schedule! I am feeling strangely "good" about this month...

Friday, February 15, 2013

Holy smokes!!!

I got DH's sperm analysis numbers in the mail today....
I now know why we get pregnant SO easy ( not that it matter if you cant stay pregnant...)....Oh my!

He had over a billion swimmers in his sample!  214 million sperm per ml, With a volume of 5.8 ml (total sample volume) that's 1,241,200,000 total.... Count, morph and motility were great, as was everything else. I was glad to hear it when the nurse called me last week to tell me all looked great, but it is even better to SEE the results! It gave DH a nice ego boost too ;)

For those who know how to read these, here are the exact numbers...

In other news...Still waiting on that + OPK...Lot's of cramps and CM, but OPK's are still no where near positive...So, I wait, and keep POAS...LOL...
That is about it...

Wednesday, February 13, 2013

I will be alright...

I know there is a rainbow
For me to follow
To get beyond my sorrow
Thunder precedes the sunlight
So I'll be allright
If I can find that
Rainbow's end

I will be allright
If I can find that

New page-

One more thing...I added a new "page" to my tabs up top ( under my blog title) with info on immune system infertility. It is LONG and filled with a wealth of info! So if you or anyone you know is looking for some basic info, and links to sites with more in depth info, on immune infertility, check out the stuff on that tab.


This cycle is so much more boring, cause I am not being monitored, and have NO idea when O will happen, and I am just kind of waiting for the OPK's to get some action on them...I am def getting lines but no where near positive. I am however getting LOTS of EWCM, much earlier this cycle, than last, so that is GOOD!

I am sooooo ready for the TWW...I ordered some OSOM tests this time ( they are the VERY BEST, and use BLACK dye, so there is not "is it pink or not" crap), I am NOT fooling with FRER anymore, they are giving terrible indents due to the deep antibody strip they have now put in the tests...Bleh! I Also ordered 100 wondfo's just to satisfy my urge to POAS whenever I so desire. LOL

Other than that, nothing new...Still waiting on results from the immune panel, and counting down the days to my appt with Braverman.

Friday, February 8, 2013

Whoa...side effects...

Cycle day 7 here...Feeling the side effects....YUCK!!

I have had some cycles in the past when I did Femara, and  I had some mild side effects, but I can certainly say this is the worst out of all the cycles! I have thrown up the last two mornings, I am having terrible headaches, I feel weak, moody and I cannot stop crying at EVERYTHING! UGH!  I sure hope this means it  (the med) is doing it's  job REALLY well this cycle and prepping my eggs to be "the ones" that stick...Otherwise, I may never do another medicated cycle again, cause this is really nasty! =/

In other news, I ordered my trigger inject. Not sure I will use it this cycle or not, but at least I have it ordered and on hand for whenever I feel like I want to use it in a future cycle etc. I plan to stock up on my progesterone in oil too, just to cut back on the expense later on...It adds up with 80 bucks here, 100 bucks there etc...Feels nice to be ahead of the game, so to speak.

........I plan to spend the rest of today, lazing around watching reruns of Grey's Anatomy,  watching the snow fall, drinking hot cocoa, and just do nothing...Hubby with be home soon form work due to the storm (Winter storm "Nemo" lol) and Kids are all home today as well, as the schools called it a snow day...We have the sledding tubes all ready to go, just waiting for the snow to pile up.

Thursday, February 7, 2013

SA was good!

Just got the call back form the RE office....DH's SA was EXCELLENT! Count, motility and morph were perfect! I don't have exact numbers yet, but I will get them in the mail in the next 3 days. So we can cross that off the list of things to worry about/get tested. Now we just wait for reposource panel results, and count down to out appt with Braverman!

Oh and, Lionna from repro called, just to let me know all the stuff got there safe and sound (and before the HUGE snow storm we are about to get!). Yay for that too! 

Wednesday, February 6, 2013

Done with blood draw!

Yay!! It is DONE! ( immune panel blood draw) 24 vials of blood later (only 6 for DH)...LOL...But at least it is all over now! The blood/vials is being shipped back to reprosource tonight via Fed EX. Hopefully I will have results in a couple weeks. Hubby also gave his sperm sample to be checked out, so hopefully we will see results for that soon!

I am feeling very happy to know we are on our way to some answers, and hopefully a plan that will bring us a take home baby!!

Tuesday, February 5, 2013


I am scheduled with Dr. Braverman, (again, we had to cancel our Oct appt due to DH's work schedule and finances) in Wodburry, Long island, NY, for a in office consult on March 21st,  to go over my labs that I am having done tomorrow at my local RE office. I am doing the immune panel tests with reprosource, that will help us determine a better path for us in getting that take home baby. I am excited to start this new part of our journey, but also a little sad, that is had to come to this...This is pretty much our "last resort" in regards to medical intervention/help with the losses. So that has been a hard pill to swallow, but it is what it is!

I will follow up with details tomorrow about the blood draw. I am anxious to see how it all goes, and even more anxious to see what DH's SA results will be. Here is hoping all goes super smooth!

Monday, February 4, 2013

All good.

I got off the phone with Lj at reprosource and we are all set to go, and ready for testing wed morning. I am going to have to push it back a tad ( a half hour) just because the kit will not arrive until 10:30, and they want the dry ice there for the vials when they do the draw. DH will be with me for the draw as well, and he is also going to do a SA too that morning.

I have also decided to do the Femara this cycle (which I start tonight)...I MIGHT do the trigger upon a + OPK this cycle...Not sure yet....Here is hoping the testing will "scare" my body into submission and this month will give us a sticky!...Not likely, but can hope...If nothing else, at least I will be on my way to answers and hopefully a solution to all the losses...

CD 3 labs

Everything came back fine...

E2 37.88
FSH 7.26
LH 5.58
HCG <1
TSH 1.94
P4 0.73

Even my thyroid (TSH) has kind of leveled off and isn't so hyper anymore after the med change...Anyway...Not sure what, if anything we are doing this cycle...I could do a un-monitored femara cycle since I have the meds on hand, but I just am not sure I am feeling it...I am kind of feeling anxious about the testing wednesday  even though I know results wont be back for a couple weeks...It is scary to start going down this road...I wish more than anything we could get a super surprise sticky bean while waiting for the test results, and need NO meds to carry to term...that would be ideal, but I am not going to hold my breath...After all, I was convinced the intralipids would be the "fix" we needed and we would not even need to travel to NYC...That did not work out so well...=/

But at least I can be happy knowing my CD 3 labs are not too whacky and everything is baseline. there is some joy in knowing things are working well at least to an extent.

I will keep you all posted on what we decide for this cycle...

Sunday, February 3, 2013

N-acetyl cysteine for recurrent pregnancy loss.

I found some great info on this supp. I just ordered some and will be taking it as soon as I have done my reprosource testing, to not skew the tests artificially. ( I stopped my fish oil too)...Anyway, here is some info on it! Lengthy, but worth it!

N-acetyl cysteine comes from the amino acid L-cysteine. Amino acids are the building blocks of proteins. N-acetyl cysteine has many uses as medicine.

N-acetyl cysteine is used to counteract acetaminophen (Tylenol) and carbon monoxide poisoning. It is also used for chest pain (unstable angina), bile duct blockage in infants, amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease), Alzheimer’s disease, allergic reactions to the anti-seizure drug phenytoin (Dilantin), and an eye infection called keratoconjunctivitis. It is also used for reducing levels of a type of cholesterol called lipoprotein (a), homocysteine levels (a possible risk factor for heart disease) and the risk of heart attack and stroke in patients with seriouskidney disease.

Some people use N-acetyl cysteine for chronic bronchitis, chronic obstructive pulmonary disease (COPD), hay fever, a lung condition called fibrosing alveolitis, head and neck cancer, and lung cancer. It is also used for treating some forms ofepilepsyear infections; complications of kidney dialysischronic fatigue syndrome (CFS); an autoimmune disorder called Sjogren’s syndrome; preventing sports injury complications; radiation treatment; increasing immunity to flu and H1N1 (swine) flu; and for detoxifying heavy metals such as mercury, lead, and cadmium.

N-acetyl cysteine is also used for preventing alcoholic liver damage; for protecting against environmental pollutants including carbon monoxide, chloroform, urethanes and certain herbicides; for reducing toxicity of ifosfamide and doxorubicin, drugs that are used for cancer treatment; as a hangover remedy; for preventing kidney damage due to certain X-ray dyes; and for human immunodeficiency virus (HIV).

Healthcare providers give N-acetyl cysteine intravenously (by IV) for acetaminophen overdose, acrylonitrile poisoning, amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease), kidney failure in the presence of liver disease (hepatorenal syndrome), chest pain in combination with nitroglycerin, heart attack in combination with nitroglycerin and streptokinase, and for helping to prevent multi-organ failure leading to death.

N-acetyl cysteine is sometimes inhaled (breathed into the lungs) or delivered through a tube in the throat to treat certain lung disorders such as pneumonia, bronchitis,emphysemacystic fibrosis, and others.

How does it work?

N-acetyl cysteine treats acetaminophen (Tylenol) poisoning by binding the poisonous forms of acetaminophen that are formed in the liver. It is also an antioxidant, so it may play a role in preventing cancer.

Here are some awesome studies on how it can help with recurrent miscarriage in women.

600 mg N-Acetyl cysteine boosts the chances of pregnancy continuing past 20 weeks by 190%

Pregnancy could be associated with a state of oxidative stress that could initiate and propagate a cascade of changes that may lead to miscarriage. This process of oxidative stress may be suppressed by the antioxidant effect of N-acetyl cysteine. The current study aimed to evaluate the effect of N-acetyl cysteine therapy in patients diagnosed with unexplained recurrentmiscarriage. A group of patients with history of recurrent unexplained miscarriage were treated with N-acetyl cysteine 0.6 g + folic acid 500 microg/day and compared with an aged-matched group of patients treated with folic acid 500 microg/day alone. N-acetyl cysteine + folic acid compared with folic acid alone caused a significantly increased rate of continuation of a living pregnancy up to and beyond 20 weeks (odds ratio = 2.9). N-acetyl cysteine + folic acid was associated with a significant increase in the take-home baby rate as compared with folic acid alone (odds ratio = 1.98). In conclusion, N-acetyl cysteine is a well-tolerated drug that could be a potentially effective treatment in patients with unexplained recurrentmiscarriage.

N-acetyl cysteine boosts pregnancy rates by 40% and lowers miscarriage odds by 60% in PCOS women

Patients with clomiphene citrate-resistant PCOS who underwent unilateral ovarian drilling were assigned randomly to receive either N-acetyl cysteine 1.2 g/d or placebo for 5 days starting at day 3 of the cycle for 12 consecutive cycles. A significant increase in both ovulation and pregnancy rates was observed in the N-acetyl cysteine group, compared with placebo [87% versus 67% (odds ratio = 1.3) and 77% versus 57% (odds ratio 1.4), respectively]. Moreover, miscarriagerates were significantly lower and live birth rates were significantly higher in the N-acetyl cysteine group [8.7% versus 23.5% (odds ratio 0.4) and 67% versus 40% (odds ratio 1.7), respectively]. In conclusion, N-acetyl cysteine is a novel adjuvant therapy after laparoscopic ovarian drilling for clomiphene citrate-resistant women with polycystic ovary syndrome(PCOS) which might help improve overall reproductive outcome.

N-acetyl cysteine boosts ovulation, progesterone and endometrial thickness in PCOS women

Patients had clomiphene citrate tablets alone or with N-acetyl cysteine 1,200 mg/day orally for 5 days starting on day 3 of the menstrual cycle. RESULTS: Ovulation rate improved significantly after the addition of N-acetyl cysteine (17.9% versus 52.1%). Although the number of mature follicles was more in the N-acetyl cysteine group (2.1 versus 3.2), the difference was not statistically significant. The mean estrogen levels at the time of human chorionic gonadotropine injection, serum progesterone levels on days 21-23 of the cycle, and the endometrial thickness were significantly improved in the N-acetyl cysteine group. CONCLUSION: N-Acetyl cysteine is proved effective in inducing or augmenting ovulation in polycystic ovarypatients.

N-acetyl cysteine boosts ovulation rate from 1% to 49% in PCOS women

The patients were assigned randomly to receive either N-acetyl cysteine 1.2 g/d or placebo with clomiphene citrate for 5 days starting at day 3 of the cycle. RESULTS: Combination of clomiphene citrate and N-acetyl cysteine significantly increased both ovulation rate and pregnancy rate in women with clomiphene citrate-resistant PCOS (49.3% vs. 1.3% and 21.3% vs. 0%, respectively). No cases of ovarian hyperstimulation syndrome were reported in the N-acetyl cysteine group; two cases of miscarriage (12.5%) were reported. CONCLUSION(S): The N-acetyl cysteine as an adjuvant to clomiphene citrate was more effective than placebo for clomiphene citrate-resistant patients with PCOS. It is safe and well tolerated.

N-acetyl cysteine does not offer any additional benefit to clomid treatment

Patients in the study group were treated with clomiphene citrate (50-mg tablets) twice per day and with N-acetyl cysteine (1,200 mg/d orally) for 5 days starting on day 2 of the cycle. Patients in the control group were treated with clomiphene citrate with sugar powder. RESULT(S): There were no statistically significant differences between the two groups in the number of follicles sized >18 mm, mean estrogen levels, serum progesterone, or endometrial thickness. Pregnancy rate was comparable in both groups (22.2% vs. 27%). Miscarriage rate was comparable in both groups (6.7% in the study group vs. 7.4% in the control group). CONCLUSION(S): N-Acetyl cysteine is ineffective in inducing or augmenting ovulation in patients with unexplained infertility and cannot be recommended as an adjuvant to clomiphene citrate in such patients.

N-acetyl cysteine does not significantly improve pregnancy rate in women with male factor infertility

Women undergoing intracytoplasmic sperm injection cycles due to male factor infertility were randomly assigned to receive either long protocol or long protocol plus N-acetyl cysteine. Clinical pregnancy was the primary outcome. Clinical pregnancy rate was insignificantly higher in N-acetyl cysteine group (52.6%) than control (47.4%).

N-acetyl cysteine protects pregnancy from maternal inflammation

Maternal infection or inflammation may induce fetal inflammatory responses and potentially fetal brain injury. We sought to determine whether prophylactic n-acetylcysteine, a known antiinflammatory, may modulate the fetal cytokine response to maternal lipopolysaccharide (an endotoxin injected to create a strong immune response). N-acetyl cysteine beforelipopolysaccharide injection significantly reduced the fetal IL-6 and IL-1 beta response. Fetal IL-10 was not attenuated by any treatment. N-acetyl cysteine attenuated both maternal pro- and antiinflammatory responses to lipopolysaccharideinjection. CONCLUSION: Maternal N-acetyl cysteine suppressed fetal and maternal inflammatory responses to maternallipopolysaccharide injection. These results suggest that prophylactic N-acetyl cysteine may protect the fetus from maternalinflammation.

Glutathione peroxidase is lower in women who miscarry

Red cell and plasma glutathione peroxidase activities of women who had had a miscarriage were significantly lower than in both normal pregnancies and the control group (n-acetyl cysteine is a precursor to glutathione peroxidase). The decreased activities of the antioxidant enzymes, red cell and plasma glutathione peroxidase, may play an important role in the aetrology of miscarriage.

N-acetyl cysteine reduces mercury levels in woman and fetus

Many people, by means of consumption of seafood or other anthropogenic sources, are exposed to levels of methylmercury that are generally considered to be quite low, but that may nevertheless produce irreversible brain damage, particularly in unborn babies. Because N-acetyl cysteine is effective at enhancing methylmercury excretion when given either orally or intravenously, can decrease brain and fetal levels of methylmercury, has minimal side effects, and is widely available in clinical settings, N-acetyl cysteine should be evaluated as a potential antidote in humans.

N-acetyl cysteine prevents heart disease in offspring induced by maternal low protein diet

A maternal low protein diet throughout gestation significantly impairs recovery of the 6-month-old adult rat heart to myocardial ischaemia-reperfusion-induced injury. Undernutrition during development may increase susceptibility to coronary hard disease by impairing recovery from coronary events. Pre-treatment with N-acetyl cysteine prevented this impairment of recovery in maternal low protein male offspring and improved recovery in all females. Myocardial infarct size was not different between dietary groups after ischaemia-reperfusion, but N-acetyl cysteine pre-treatment significantly reduced the degree of infarction.

N-acetyl cysteine helps prevent diabetes induced birth defects and miscarriage

We found decreased Bcl-2, increased Bax and cleaved Caspase 3 proteins in embryos from diabetic rats. Moreover, we found increased activation of Caspase 3 in cells from embryos previously exposed to a diabetes-like environment (in vivo, in vitro) compared to cells from control embryos, which was normalized by supplementation of N-acetylcysteine or apoptosis inhibitor. Additionally, we found increased dysmorphogenesis in embryos exposed to a diabetic environment in vivo and in vitro. Exposure to a diabetic milieu during organogenesis increases apoptosis in embryonic cells and dysmorphogenesis in embryos. Enhanced apoptotic rate may have a role in diabetic embryopathy by inducing disturbed embryonic maturation, increased rates of resorptions and congenital malformations.

Taking N-acetyl cysteine before infection protects fetus; N-acetyl cysteine after onset hurts

The present study investigated the effects of N-acetyl cysteine on lipopolysaccharide injection-induced (injection creates the same inflammatory effect of infection) intrauterine fetal death and intrauterine growth restriction. Results showed that pretreatment with N-acetyl cysteine significantly alleviated LPS-induced fetal mortality and reversed lipopolysaccharide injection-induced growth and skeletal development retardation. By contrast to pretreatment, when administered after lipopolysaccharide injection, N-acetyl cysteine did not protect against lipopolysaccharide injection-induced intrauterine fetal death and intrauterine growth restriction and in fact aggravated lipopolysaccharide injection-induced preterm labor. Pretreatment with N-acetyl cysteine improves fetal survival and reverses lipopolysaccharide injection-induced fetal growth and skeletal development retardation, whereas posttreatment with N-acetyl cysteine aggravates lipopolysaccharide injection-induced preterm labor.

N-acetyl cysteine helps protect placenta from high homocysteine levels

Hyperhomocystinemia is a thrombophilic condition associated with placental dysfunction. Homocysteine-thiolactone induced a concentration dependent increase in total cell death and death by apoptosis, compared with control. Vitamin Cameliorated apoptosis in cytotrophoblasts, whereas N-acetylcysteine ameliorated cell death in syncytiotrophoblasts.CONCLUSION: Homocysteine-thiolactone enhances apoptosis in cultured human trophoblast, and the effect can be limited by antioxidants.

N-acetyl cysteine reduces incidence of birth defects caused by maternal consumption of alcohol

In the present study, the hypothesis that coadministration of N-acetyl cysteine and ethanol by means of liquid diet on days 7 and 8 of pregnancy in mice would reduce ethanol's teratogenicity was tested. Although the lower dosage of N-acetyl cysteine (300 mg/kg) resulted in a decrease in the incidence of ocular defects in both the left and right eyes, this reduction was not statistically significant. However, doubling the N-acetyl cysteine concentration did yield a significant change; as compared with the group treated with ethanol alone, the incidence of ocular abnormalities was diminished by 22%. These results show the potential of an orally administered compound with proven clinical efficacy to reduce ethanol's teratogeniceffects and support the premise that oxidative damage plays an important mechanistic role in fetal alcohol spectrum disorders.

1000 mg N-acetyl cysteine per kilogram of body weight per day causes infertility

The toxic effects of i.v. administration of N-acetyl-cysteine, a component of parenteral nutrition solutions, on fertility and embryonic development were investigated in male and female rats at doses of 100, 300, and 1000 mg kg-1 day-1. Infertility was observed in females in the 1000-mg/kg group (equivalent to 54,000 mg /day for a 120 lb woman) throughout the period from before mating to embryogenesis. No effect of N-acetyl-cysteine on the reproductive ability of the male rats was seen.

N-acetyl cysteine does not cause birth defects in rats or rabbits

With regard to the reproductive and developmental toxicity of orally administered N-acetyl-cysteine, Bonanomi and Gazzaniga
reported that no effects were observed in a male rat fertility study at daily doses of 250–1000 mg/kg, in a rat teratogenicity study at daily doses of 500–2000 mg/kg, in a rabbit teratogenicity study at daily doses of 250–1000 mg/kg, and in a rat peri- and postnatal study at daily doses of 250–1000 mg/kg. Johnston et al. also reported that oral administration at a dose of 500 mg/kg/day from
Gestational Day (GD) 6 to GD16 showed no teratogenic effects in the rabbit. Thus, a number of studies have examined the reproductive and developmental toxicity of orally administered N-acetyl-cysteine.

1.8g N-Acetyl cysteine improves insulin resistance and lowers testosterone in PCOS subjects

Patients were treated for 5-6 weeks with N-acetyl cysteine at a dose of 1.8 g/day orally. A dose of 3 g/day was arbitrarily chosen for massively obese subjects. Six of 31 obese patients with PCOS were treated with placebo and served as controls. Fasting glucose, fasting insulin, and glucose area under curve were unchanged after treatment. Insulin area under curve after oral glucose tolerance test was significantly reduced, and the peripheral insulin sensitivity increased after N-acetyl cysteine administration, whereas the hepatic insulin extraction was unaffected. The N-acetyl cysteine treatment induced a significant fall in testosterone levels and in free androgen index values. In analyzing patients according to their insulinemic response to oral glucose tolerance test, normoinsulinemic subjects and placebo-treated patients did not show any modification of the above parameters, whereas a significant improvement was observed in hyperinsulinemic subjects.CONCLUSION(S): N-acetyl cysteine may be a new treatment for the improvement of insulin circulating levels and insulin sensitivity in hyperinsulinemic patients with polycystic ovary syndrome.