TH1/TH2 Ratio Significance

[Luvmyboys]

Dr. Braverman,

I have completed most of the tests on the Couples Immune Panel and all results have come back normal (no blood clotting, no ANA, normal NK activity, etc.). The only thing that seems odd is the following:

TNF-A:IL-10 = 31.8 (Reprosource shows the normal range for fertile women to be 14.1-39.4 and that 31.9 is the borderline elevated level in the infertile population)
IFN-G:IL-10 = 7.4 (Repsosource shows the normal range for fertile women to be 3.7-17.6 and that 12.4 is the borderline elevated level in the infertile population)

NK cells are normal (activation test) and they are actually low normal on the Reproductive Immunophenotype (5.5). NK assay showed the highest value to be 8.9.

I have only had one chemical pregnancy of a normal embryo. My previous history has been two boys conceived first month trying and never had a miscarriage before the IVF transfer. The IVF transfer was not of a high quality embryo (was delayed in development compared to the other).

I am just curious if you see anything significant with the TNF-A results above? I am not planning on treating them with steroids because I think that might suppress the IFN-G levels too low and also because it doesn't really seem they are elevated. I am a huge stressball so I wonder if that could cause that to be a little bit borderline. Is that possible?

No immune issues run in my family and we have a pretty uneventful pregnancy history. I had 2 full term pregnancies with scheduled cesareans because my pelvis is too small (will not expand to accommodate a baby). I do harbor a ton of stress due to my everyday life (I work full time, help my husband run his business, run my own side business, and am just a very active person running around trying to do everything all the time). I am going for my second transfer in about 2 weeks so I thought I would see what you thought about the ratios above and if I should try steroids or not.

Thank you!

[LuvmyXY]

Clearly, I'm not Dr. Braverman and not a reproductive immunology expert, so please pardon my putting in my 2 cents.

However, before my FET, I got immuno results in which my TH1/TH2 ratio was off. I went on high doses of Vitamin D for 3 months prior to transfer (raising my levels from 34 to 78), and this normalized my TH1/TH2 ratio. It might be worth asking your doctor. Hope this helps and best of luck to you!

[Luvmyboys]

Clearly, I'm not Dr. Braverman and not a reproductive immunology expert, so please pardon my putting in my 2 cents.

However, before my FET, I got immuno results in which my TH1/TH2 ratio was off. I went on high doses of Vitamin D for 3 months prior to transfer (raising my levels from 34 to 78), and this normalized my TH1/TH2 ratio. It might be worth asking your doctor. Hope this helps and best of luck to you!

That's funny you mention that because my vitamin D levels are low normal (43)! That sounds very likely that could be the issue since its barely elevated and nothing else has come up as any concerns.

I will add in my high dose of vitamin D and hope that should help.

Do you mind me asking you what your levels were when they were tested prior to the vitamin D?

Thank you so much!

[LuvmyXY]

That's funny you mention that because my vitamin D levels are low normal (43)! That sounds very likely that could be the issue since its barely elevated and nothing else has come up as any concerns.

I will add in my high dose of vitamin D and hope that should help.

Do you mind me asking you what your levels were when they were tested prior to the vitamin D?

Thank you so much!

Just seeing this and getting your private message. I just messaged you back.

[Dr. Braverman]

Did you get my reply from my website forum , I responded to your post their. Just to say that Vit D is very important as another poster has pointed out, but many times low Vit D is a result of an immune issue or exacerbates an underlying issue. It should never be looked at as the sole issue in cases of recurrent pregnancy loss , but certainly as a significant contributor.

[Luvmyboys]

I did see it. Thank you.

Can chronic stress cause the inflammation? As in I have to go to regular counseling because I worry chronically.

Would having no family history of auto immune mean anything?

Are low dose steroids harmful in cases with borderline elevated cytokines?