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Discussion Starter · #1 ·
Hi Peter

Have had the blood test for the above today.

Could you please explain to me what this is?

Love Louxxxx
 

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Hi Lou,

They are Natural Killer Cells - I found this.....

Immune disorders are one of the most common causes of severe infertility in women with endo. In particular, we find that immunologic problems are especially common in women who suffer from severe infertility - patients that do not become pregnant despite repeated treatment with aggressive therapies such as IVF.

While many aspects of immune disease may affect fertility, we find that abnormal activation of natural killer (NK) cells is the most important immune problem in infertile women with endo. NK cells are white blood cells that are an important part of the immune system's innate defense against foreign invaders such as bacteria and viruses. NK cells are one of the most common cell types found in the uterus in early pregnancy.

Research reveals that NK cells play an important role in early pregnancy. In normal pregnancy the embryo, placenta and fetus communicate with NK cells and other immune cells in the lining of the uterus. This communication sets the stage for the orderly development of pregnancy. NK cells produce growth factors that stimulate the development of the implanting embryo in early pregnancy. These growth factors are essential to the growth of a normal placenta. High rates of miscarriage and fetal growth retardation are seen in animals that are deficient in NK cells and/or the immune hormones they produce.

Additionally, NK cells are thought to prevent excessive ingrowth of the placenta into the wall of the uterus, preventing the formation of placental tumors. Thus, NK cells might be thought of as a director of early pregnancy, stimulating embryo growth to ensure normal early development on one hand, while standing by to protect the body against excessive placental invasion and tumor formation.

Basic research demonstrates that NK cells are markedly altered in some women with endo. Excessive activation of uterine NK cells is found upon examination of uterine tissues from women with endo and resistant infertility. It appears that activated NK cells attack the implanting embryo causing infertility and/or repeated miscarriage.

Blood testing for NK cell activation is used to diagnose NK cell-mediated immunological infertility. This testing must be performed in specialized reproductive immunology laboratories having expertise in this area. In many of these laboratories a value of greater than 12% NK cells is diagnostic of excessive NK cell activation and immune infertility. In our experience at the Sher Institutes, approximately 30% of women with endo and severe infertility test positive for NK cell activation. We find that women who suffer from endo and repeated IVF failure that have a positive NK test require immune therapy to have an acceptable chance of pregnancy.

Antiphospholipid antibodies (APLA) and antithyroid antibodies (ATA) have also been implicated in immune-based infertility. The association between a positive test for these autoantibodies and reproductive dysfunction is much less clear than NK cell activity. Some experts believe that these antibodies may serve as a marker for underlying immune disorders that affect reproductive performance. Other specialists assert that certain antiphospholipid antibodies directly affect fertility. On the other side of the argument, there is a body of research that finds no association between antiphospholipid antibodies and the outcome of treatment with IVF. In Dr. Sher's experience, women with endo that test positive for APLA are extremely likely to have a positive NK cell test as well, necessitating immune therapy to help them become pregnant. It is clear that women with antiphospholipid antibodies who do become pregnant are at substantially higher risk of subsequent miscarriage.

The causes of immune disorders that cause infertility in women with endo are unknown. Some experts believe that NK cell activation and antiphospholipid antibodies are the result of the body's attempt to attack and rid itself of endometriosis, analogous to the immune reaction used to fight early cancers. Others believe that immune disorders are the cause of endometriosis and that infertility is just another manifestation of immune disease.

It is observed that women that have a personal or family history of autoimmune diseases, including thyroid disease, rheumatoid arthritis, and system lupus erythematous may have a predisposition to both endo and immunologic infertility. It is important to note that while women with endo may be found to have abnormal immune tests, these patients rarely suffer from overt immunologic diseases that affect their health. Endometriosis does not seem to impart a higher personal risk of the severe autoimmune diseases listed above.
Hope that helps.
 

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Discussion Starter · #3 ·
Thanks Tony for this


if it is postive I have so much too look forward too!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! :(
 

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Discussion Starter · #5 ·
Thanks Sue for the links


I have phoned for the results today but have to phone back tomorrow to speak to Dr Thum, he is the person apparently at The Lister who only deals with this problem.

I know it is steroid treatment if it is positve. I am really hoping it isnt to be honest.

We were told yesterday we had to have the test before we could have any more IVF cycles which was strange. So we did............ :p I think it is fairly common in women with unexplained infertility.

If this is go is negative I am having a laparposcopy done and ovarian drilling, ouch.

I start sniffing on Sunday for my next go and am on very low dose of Puregon this time, 100iu per day instead of 200.

Gafar profusly apologised for the cock ups so we are starting a fresh with them. We will change clinic if we are not happy this time. He was very angry at the mistakes that had been made and went straight out to speak to the sister on duty at the time. I had the letters with me that had been sent to me in error.

Anyway thats it for now I guess

Love Lou xxx
 

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Hi Lou

Dr Thum is lovely! You have to tune into his accent a bit on the phone but he's great! He does research at St Helier's hospital (Carshalton) into NK cell's etc on a Wednesday so he isn't at the Lister then (that's why you couldn't speak to him today!)

The results should take up to 7 days? I think he does the testing at St Helier's? So they may be available tomorrow!

The test is now becoming more common if IVF cycles aren't working when there appears to be no reason why........... I had my NK cell test done in February before our FET (which was before the last fresh). The test showed Negative (thankfully). There is another test that they are currently doing with me on activated NK cells (being a guinea pig for it!!!!!!!!!!!!) and currently waiting for results!!!! ::)

Lower dose this time you will be fine. They reduced my dose down to 75iu and I got better results on it! and reduced OHSS!

I'm glad they apologised (doesn't make it right but better that they do that) and they are taking steps to ensure stuff like that doesn't happen again, you don't need it.

All the best for sniffing from Sunday.....

Love Sue
xxxxxxxx
 

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Discussion Starter · #7 ·
Still no results.................. :-\
 

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Lou - did you call or not?

Love Sue
xxx
 

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Discussion Starter · #10 ·
Hello all

Thought some of you may be interested to know that I do infact have very high levels of these horrible killer cells. Normal is below 12 and mine is infact 24!!!!!! :eek:

The consultant at The lister that specialises in this even thinks that this could have something to do with our unexplained infertility and the embryos are being eaten by the killer cells before implantation.

Not sure what I think right now, trust me to be complicated as usual. So it will be the dreded steroids for me from now on. :mad:


Girls I think if you are unexplained maybe you should ask about the test. it has only just been offered to me
Love Lou xxxx
 

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Lou,

I am so glad that they have found this now, bizarre if they know about these NK cells that they dont test unexplained infertility people sooner for this :-\ or in fact they should do it routine for all couples.

It puts you one step closer now hun, it will be worth taking the steroids to get that dream now.

Hugs

Mel

x x
 

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Lou,

Thanks for the info, even although its a lot to take in right now. You are one step further to getting your dream.

Take care,
Luv
Gail x

p.s. I may be wrong but just can't shift this from my head that it could be our reason for unexplained as well.
 

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Hi Lou

I too am pleased for you that you have found out your "reason".

The steriods will be a small price to pay to make your dream come true.

Good luck
Love
Dee
xxx

PS - Hope it's not glandular fever you've got ... you're certainly not having an easy time of it lately - hope things look up soon. xx
 

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Discussion Starter · #14 ·
Just wondering just how fat I am going to get on those steroids :eek: :eek: :eek: :eek: :eek: :eek:

Thanks girls for all your messages, your all fab x
 

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Dear Lou

Wow, what a breakthrough ! I am pleased they found a reason for you, its so rare with un-explained that anyone finds out a reason, this must have given you so much hope and I am really pleased for you !

Load & loads of luck Lou x x x

Love Amanda x
 
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