NK cell test: blood vs endometrial biopsy, or both?

[MofM]

Hello,

I am wondering whether testing for NK cells, and my clinic offered me two options: endometrial and blood test. They actually suggested having both, but this is quite taxing financially (about £1000), so I am now wondering which one to choose and if having both is really giving better results.

What is your opinion? Is your clinic also suggesting having both blood test and endometrial biopsy?

More in general, is this test really giving useful information? To the best of my understanding this is red on the HFEA website, and, due to the pandemic, also if a raised NK cell level is detected, no medication can be prescribed, making it a bit useless...

[Krystal_43]

So I’ve spent quite a lot of time looking into this (-academic papers and forums). And from what I understand:

1. Uterine natural killer cells (biopsy) are different to peripheral ones (blood)

2. Biopsy result & blood test can lead to different diagnosis (eg high uterine & low peripheral or vice versa). Research shows they aren’t necessarily correlated. BUT both are linked to auto immune disease (eg crohns) so there must be a link somewhere!!!

3. Biopsy results are what most of the research into nk cells & fertility is based on. But results of a biopsy can fluctuate, so its best practice is to get two done to ensure reading is accurate (you’ll find lots of people who get normal in one, low in the next etc).

Because of that, I opted for a biopsy in Coventry (they do 2) & was diagnosed with very high. Haven’t had treatment yet - just waiting for a good time to do a cycle, but they will prescribe it for me (ie won’t be affected by covid).

That said, lots of ladies on here have done bloods to be diagnosed with nk cells after failed transfers, received treatment & are now pregnant - so both methods work! I guess if one method of diagnosis comes up as high, you probably don’t need to bother with another. Though if it comes back fine you might want to double check the other?

[Wonder_Dog in reply to Krystal_43]

MofM Krystal_43 has given a great summary there. After 2.5 years of never seeing a BFP, including after 3 IVF embryo transfers, we’re convinced it is my high uterine NK cells (as detected in a biopsy) that is to blame.

We’re bout to sign up to a different clinic, and will only be signing up to one who *will* give us treatment for high uNK cells first.

Like Krystal I’ve done enough ready (both studies and anecdotal stories on forums etc.) to believe this is a treatable issue.

Don’t forget, red on HFEA rating doesn’t mean “it doesn’t work”, it simply means there aren’t enough studies completed yet that show that it does i.e. it’s just under researched!

Good luck with whatever you go for x

[MofM in reply to Wonder_Dog]

Thanks for your sharing your story. Did you have the biopsy alone? Was it repeated as suggested above by Krystal_43 ?

[Wonder_Dog in reply to MofM]

Yes we just went for the biopsy alone. We did have other blood tests done around the same time for various other conditions, which all came back normal, so if it was tested for and I didn’t realise, it wasn’t flagged as an issue. And no, we didn’t have it repeated, that hasn’t been suggested to us yet.

[MofM in reply to Wonder_Dog]

Thank you!

[MofM in reply to Krystal_43]

Thanks for the detailed answer. I think I will go for the biopsy alone then, and be happy with whatever result I get. We can't really afford blood and/or a second biopsy.

My clinic said that apart from intralipids they can't prescribe anything else. How can you have steroids prescribed?

[Millbanks]

It’s a tricky choice but I just did bloods (Chicago bloods) and the NK cells came back high. For our next (6th) FET I had low dose steroids and intralipids and we got our first ever positive. We had also had the ERA test timing adjustment and we’re transferring a PGS tested embryo, but am convinced that the steroids were the key 👍🏼❤️