NK Cells Testing

[Libsie3103]

Just wondered if any of you had been tested for NK Cells for either implantation issues or miscarriage? And if so at what stage in your journey you did it?

We've had 1 failed IVF and 1 MMC of twins and were TTC naturally for 2 year before that. I know I'm trying to find straws to clutch at but I'm just wondering if that could be the issue and would be interested to hear other people experiences.

Are there any other tests people would recommend? I have my follow up appt at the clinic on Tuesday but my GP is doing bloods for Lupus & APS.

Thanks!

[waitingg]

Hi Libsie, I’m sorry to hear of your losses.

We had the killer cell tests along with various other bloods.

We had clear male factor issues but had 3 failed transfers and then one chemical. Our clinic didn’t believe in anything that wasn’t Hfea regulated which was becoming tiresome and frustrating just seeing our blastos fail and them only tweaking protocol.

We went for testing at a private London clinic and I was pretty sceptical tbh. But my killer cells came back much higher than normal and showed that ivig was the best at bringing my levels back.

I had the tests about a month and a half after my chemical as we were having a few months break from treatments but I can’t remember there needing to be a certain time to have it done. The IVIg were expensive and made the cycle more tiring but we are finally pregnant. We also did IMSI that cycle so that may well have made a difference too.

From my experience it seemed to be very dependent on what clinic you are using as to what they suggest doing next. Sorry for long message!! Lots of luck xxx

[Libsie3103 in reply to waitingg]

Thank you for your response and sorry for my delayed reply. That's helpful to know. I have chatted it through with my clinic and they've suggested I don't test but they treat me as if it's positive with steroids which won't have a negative effect. Saves the time and yet more ££!! It's such a hard journey with so many un answered questions xx

[waitingg in reply to Libsie3103]

Yes sadly the tests were expensive. Steroids are a good idea if you don’t want to test yet and they work for so many so hopefully they will work for you. From what our consultant said there are 3 main ways, steroids, intralipids or IVIg. Each person will react differently to each method and the tests test your tissue/blood against each method. For me the steroids showed no reduction, intralipids only a little and the IVIg the most. Amazes me what they can find out from blood tests!! Wishing you all the best, I found making these decisions some of the hardest parts xx

[Libsie3103 in reply to waitingg]

Thank you that's really helpful, I'd not realised any of that. He seemed to imply it would just be steroids so interesting to know there are other options. Sigh... More questions!!! xx

[waitingg in reply to Libsie3103]

Sorry don’t want to add any confusion to what already is so hard. Our original clinic was nhs and private but followed nhs/hfea protocols and they would offer the steroids without testing too. It’s not to say that wouldn’t work for you tho. The tests just give you more information.

I did have a few appointments with different private clinics about the whole immune treatment thing before deciding our next steps so DM me if you want any more info xx

[And23]

Hi Libsie

So sorry to hear about your losses.

After 2 IVF cycles resulting in 1 fresh transfer 6 FETs (1 chemical/1BFN) I was tested earlier this year for NK cells. I made my own referral to Prof Quenby/Prof Brosens at Coventry Hospital after asking my consultant if there is anything new we could try. As not HFEA regulated not every doctor would recommend but mine gave me the information and let me decide.

I had a consultation with Professor Brosens and 2 biopsies a month apart. This costs around £500. The first biopsy was high for NK cells the second was borderline. Following the results, we had a call to discuss treatment I was recommended progesterone support and prednisolone from the day of transfer.

Since I have had another IVF cycle resulting in two day 5 blastocysts, one fresh transfer with medication failed but the FET in Aug is so far successful. I’m currently 7weeks 4 days and viability scan went well. Whether this has anything to do with the medication, no one can know but I’m a firm believer in trying new things and having all the information available.

Before this cycle, I also had thyroid tests (I’m now taking 25mg levothyroxine as part of a study looking levels of TSH when trying to conceive), a repeat scan of the uterus to check for and fibroids, sticky blood test and my husband and I both had karyotype tests to rule out chromosome issues. These can all be really expensive so if you are lucky enough to have NHS funding request them while you can.

Wishing you lots of luck. xxx

[Libsie3103 in reply to And23]

Thank you so much for your reply and congratulations! Hope things are still progressing well for you. I looked into the tests / clinics in Coventry and discussed it with my clinic and they've suggested not to go for it but they'll treat me as if it was positive any way to be on the safe side as it'll have no negative effect. It's so tough as there are so many avenues we could go down and endless tests we could have. Wishing you all the best with your pregnancy xx

[Cinderella5]

Hi Lisbie, I had bloods done for NK cell testing. Mine came back slightly raised and I started having intralipids with my transfers. I was still getting BFNs and I asked if I could start prednisolone. The Dr wasnt over keen as he said there was no evidence to support this but I could have it if I wanted, yes! I have seen a fair few ladies over the years have success after trying this. I have had 2 BFP's this year since adding this....Im not sure if that's been luck or not. I should add that we've discovered I have a progesterone issie which is probably the cause of my spontaneous losses. Anyhoo if your clinic would allow you to try the meds before testing you could save yourselves a bit of money as most only recommend steriods for it anyway. Best of luck with your bloods. Hope you're doing as well as you can be. Hugs to you both.xx

[Libsie3103 in reply to Cinderella5]

Thank you so much for this. It's so tough - I feel like I'm clutching at every straw there is going and sometimes there will just be no reason... It's such a tough journey and heartbreaking at times... The clinic have agreed to me taking steroids for the next transfer just incase my killer cells were positive, they have said there will be no risk. Do you mind me asking how you identified your progesterone issue? I'll ask about intralipids as well. Thanks again for your help I really appreciate it xx

[Cinderella5 in reply to Libsie3103]

Oh that's good that your clinic are willing to listen to you, some can be quite stubborn about he steriod thing. I had my progesterone levels checked at my last positive and they were only 19nmol/l which is too low to support pregnancy. Im upping my progesterone this time around but to ensure its the correct levels we are checking them on transfer day. It may be that your levels are fine but I think its worth checking. The other thing is have you have your thyroid/prolactin checked recently? Your thyroid in particular requires to be around 2 for conception. Hang on in there, it is an extremely tough journey but you're doing all you can to fight on!! Hope you're doing as well as you can be for now.xx

[Libsie3103 in reply to Cinderella5]

Thank you so much - I really appreciate it. I'll ask my GP if she'll check my thyroid levels - I have no idea when they were last checked. I was really pleased about the steroids as not having to do the NK tests (from a time and money perspective) is a real bonus. I’m not ready to go again yet but would like to have everything in place. I’ll also ask if they can check my progesterone when they do the transfer - just trying to make sure I have done all I can.

We’re 4 weeks on now and I’m hanging in there – good days now outnumber the bad days which is progress but then I can just start crying and my world feels dark again. I’m just scared I’ll never be a Mum and turning 43 in March doesn’t help!!

xx

[Cinderella5 in reply to Libsie3103]

Yes, I thnk putting a plan in place for when you do feel ready is important. At least it allows you to feel proactive meantime. Im sure your GP will do your TSH and if you do need meds then it will allow you some time to let them kick in too. If you can get your levels check at transfer then your clinic can make any adjustments if necessary, that's what mine are planning to do.

More good days than bad is definitely progress, there will be days when things bite you on the bum when you least expect it but I think that's normal. Just do whatever you need to to feel ok. Its good to cry and get things off your chest. Im also feeling a bit scared with the age things, can relate as Im 42 in November. Big hugs.xxx

[Libsie3103 in reply to Cinderella5]

Thanks again - I really appreciate your advice and input. Means so much. I have a friend who had her first baby with IVF and then IVF twins 8 years later on her 47th birthday so I'm holding onto that!! xx

[Cinderella5 in reply to Libsie3103]

Oh that's also good to hear! You're welcome, that's what we're all here for.xx

[HopeAt43 in reply to Libsie3103]

You should check into intralipids. I am in canada and it’s $150 per infusion. I know I had preeclampsia with my daughter and I was told that intralipids would have prevented that. Just a though. Intralipids are safer to be on than prednisone. Even though it doesn’t cross the placenta, there is a small risk of cleft palate etc.

[Jm82]

Hi, sorry for your losses. In regards to further tests I've had 1 round of ivf resulting in 7 viable embryos, but 2 mmc and 2 negative results. (Transferring 1 the 1st time and then 2 For the other 3 transfers)

I had the nk test and my antibodies were slightly raised so they suggested steroids just encase. My partner had DNA fragmentation and this has come back extremely poor so we are waiting a re test. It was an expensive test and although devastating results it's given us some reasoning as to possibly why things havnt worked so far. Has your partner had any further tests at all as our clinic so far have always concentrated on me.

Good luck whatever you decide xx

[Libsie3103 in reply to Jm82]

Hi, thank you for this. My clinic have suggested steroids just incase my NK cells are positive. They said there was no point getting tested as they could give them to me any way with no impact to me or the baby. I also asked about DNA fragmentation but wasn't sure if that can change in a man as my husband has 2 boys from his previous marriage which were conceived easily / quickly? They said if that was an issue they'd just suggest ICSI which we're doing any way. The slight complication for us is that we're using frozen sperm as my husband had cancer & chemo. The number of things it could be and tests you could have is endless & exhausting! Wishing you lots of luck with your journey xx

[HopeAt43 in reply to Libsie3103]

As I mentioned above there is a small chance of issues like cleff pallet with prednisone.

[Flora14 in reply to Libsie3103]

I've asked 2 different consultants and neither will give me steroids.4 failed rounds and desperate to try them x

[Jm82]

My partner also has 3 children from a previous relationship, twins and 1x single which is why I feel they concentrated on my results more and we had Icsi due to borderline motility. It's a minefield though, so many tests you just don't know what to do for thd best.

Sorry to hear of your husbands illness I hope he's now making a full recovery. Good luck with everything, it's a tough journey. Xx

[Libsie3103 in reply to Jm82]

It certainly is! Could keep going forever if we wanted to and had the money!!!! Good luck with your journey hun xx