KIR or LAD tests for recurrent implantation failure

[Gabriella89]

Hi - does anyone have any experiences with these tests? I’ve got history of recurrent implantation failure with PGS normal embryos and high NKC. We have one embryo left and starting a protocol with humiera added to IVIG but consultant just rang and recommended these tests at another clinic. Should I be worried?

[Poppyhb]

Hi Gabriella, hope you are doing okay. I had these tests and a couple of others after 2 failed PGT transfers. I had high NK cells and was prescribed steroids for my second transfer but didn’t make a difference so I wanted to see if there could be any other implantation factors.LAD showed me and hubby have one number in common so I have to have LIT twice ahead of another transfer & be tested to see if I’ve developed antibodies. The KIR also showed I’m missing the 3 activating receptors that are required so I will be adding injections for that when we start the next transfer protocol.

The tests and treatment are expensive but for me I now know it would be highly unlikely for me to get pregnant without these changes and it would be a waste of my embryos to continue transferring on the same protocol.

I had a couple of other tests too to rule other things out. Happy to share with you if useful. Good luck with what you decide.

[Gabriella89 in reply to Poppyhb]

That’s so helpful thank you Poppyhb really appreciate you sharing this! Can I ask what other tests you’ve had please?

[Poppyhb in reply to Gabriella89]

Hi Gabriella89 and leo1980 so I had both thyroid and insulin resistance tested to make sure my NK cells weren’t battering my immune system elsewhere, came back ok so we think it is localised to my uterus.

Also had antibodies test and general immune bloods which showed overactive immune system so I am on Hydroxychloroquine (200mg twice a day) to try and general calm down the cells that are attacking anything deemed foreign (ie embryo).

I tested positive for Factor V so that means clexane will be added.

Also sent off menstral blood to Greece to check for hidden C and other infections that might be in the lining and prevent implantation. Apparently a normal smear of chlamydia test doesn’t show up these infections. I had a friend who had this and it showed up an infection so she had antibiotics and after 7 years of trying got pregnant on her first transfer.

So hoping if we can add all this into our protocol we might finally get somewhere 🤞

[Gabriella89 in reply to Poppyhb]

Thanks Poppy - did you also have IVIG or humeira at all?

[Poppyhb in reply to Gabriella89]

I will do on the lead up for my next transfer. The consultant is going to check my NK cells against intrallipids and IVIG and give me whatever one calms them the most. My current clinic doesn’t offer anything other than steroids so I’ve got to do the transfer with them but the immune protocol with my other consultant.

[Gabriella89 in reply to Poppyhb]

I’m having my NKC tested against IVIG plus humeira at the moment (just had IVIG before) how long does it take to get the results back from the LIT and KIR tests? Got my consultation with a new immune doctor on Thursday so you’ve been a HUGE help! My doctor didn’t even know about these tests until I read her your message!!

[Poppyhb in reply to Gabriella89]

Yes it’s so strange how some consultants are all for it and others have no idea. This group is a godsend for finding out new info quickly.Both results were relatively quick, less than a two week turn around. Check where they are sending them, if it’s America it should be relatively quick, it’s Europe (ie Greece) that have a few delays due to Brexit changes but even that test was pretty prompt and just over two weeks before I got the results. Good luck.

[Gabriella89 in reply to Poppyhb]

Can’t thank you enough for sharing this - hoping this might be the answer to all our worries on why we are where we are. Wishing you so much success with your 3rd transfer xx

[leo1980 in reply to Gabriella89]

Where are you having your tests Gabriella89? I will go there too

[Gabriella89 in reply to leo1980]

leo1980 My existing clinic has referred me to the Fertility and Gynaecology academy on Harley st - apparently not many clinics do these tests!

[leo1980 in reply to Gabriella89]

Thank you! I know who they referred you too. Let me know how you get on. I will also share my findings…

[Gabriella89 in reply to leo1980]

Have you been told to get these too?

[leo1980 in reply to Poppyhb]

Poppy thank you so much love!! This is so helpful….

[leo1980 in reply to Poppyhb]

Please share tests with too! Thank you

[leo1980]

I had a second opinion consultation with Dr Gorgy last year and there were a number of tests that he recommended. My issue at the time was that we went even making embryos. Total fertilisation failure for 2 cycles. Since then I did embryo banking and was able to get embryos that were PGT normal so now it’s a case of transfers but I want to tick of everything on my list before I transfer to give the embryos a good shot.

I am in the process of era and Emma - have you done those?

[Gabriella89 in reply to leo1980]

Oh wow that’s great, yes I’m seeing Dr Gorgy tomorrow! How many PGT embryos do you have? We got 3 normal from 2 cycles but now only one left, I’ve had ERA, Emma, Alice and Hysteroscopy tests plus 3 NKC tests now… I’m like you - just now throwing all my money at tests just hoping this last one will work xxx

[leo1980]

Hey. Only 4 but poorly quality like 3BC and 3BB.. did you do level 1 and 2 tests? I did those ones too. Let me know if you need me to write it out. It’s about 7 tests. How was your ERA and Emma? Ask for thromgram (can check spelling for you)

[Gabriella89 in reply to leo1980]

I've got one 3BB left but i'm trying not to worry about the grade as everyone says it's not a huge factor. What are level 1 and 2 tests? Era came back with 6 hours more projesterone needed. Emma and Alice both fine. What's a thomgram? After your ERA will you go back to Dr Gorgy to re-start immune tests?

[leo1980 in reply to Gabriella89]

I also try not to worry about the grade. So subjective right. What one embryologist might see another night not!

Here are there tests I have had:

Full blood count: fasting blood glucose, LFT, and U and E

Thyroid FT4 and TSH

Thrombotic screen

PA1-1 gene mutation polymorphism

Autoimmune antibodies- Ana, thyroid peroxidase, anti mitochondrial antibodies

The Chicago ones

Natural Killer ( cell assay)

TH1/TH2

With all this in mind the treatment plan included steroids, intralipids, clexane, and methyl folate rather than just folic acid.

Hope this helps!