Immunology - high NK cells and cytokines

[Skittles11]

Hi Has anyone had NK and cytokine tests done?

My results were high and so I did intralipids and retested and it's not helped lower them.

Feel at a loss as to what to do next.

Wondered if anyone in similar position with high NK cells / cytokines.

I'd love to hear from anyone who has had them tested and what worked. Feel like it's back to drawing board - I am very reluctant to transfer my embryo if my body has this high level of activity that may result in embryo rejection.

Please get in touch if you can offer any thing helpful xx

[K8dferXdder]

hello, I think I have messaged you before on a similar question and even though my Nk cells have been high, this didn’t prevent me getting pregnant and having on-going pregnancy.

I did IVIG once and Intealipids twice plus tPrednisolone 25mg to week 14 and even after that my NK were still high. So don’t worry too much. That’s why they say immunology is contradictive topic, don’t stress too much about it. Wishing you good luck 🤞

[Skittles11 in reply to K8dferXdder]

Hey, yes we have had messages before, thank you for replying again. I think I'm just really anxious about my body discarding the embryo, my cytokines I feel are really quite high rather than just being elevated.

I also understand what you're saying about immunology and it is quite controversial.

Part of me thinks just crack on now with transfer but I don't want to end up with regret or blaming myself.

Did you test your levels before transferring to see what was working for you?

I had the intralipids as a test to see what it would do to my levels prior to transfer xx

[User20]

hi Skittles,

I had high NK cells and was put on 25mg of prednisolone. After 3 failed transfers this was the first one that worked and resulted in my daughter. I do think the steroids has helped- I was on prednisolone for 12 weeks.

I have not had intralipids though ! Good luck 🤞

[Skittles11 in reply to User20]

Hi, thank you for replying to me. Can I ask did you just have the prednisolone and no other meds to lower the NK cells?

Did your clinic have you take the prednisilone and retest before transfer to see what the impact on levels was or did your clinic have you take them alongside the transfer without retesting?

Congratulations on your daughter xx

[User20 in reply to Skittles11]

Hi! I only had the prednisolone to lower the NK cells and did not retest. They just had me on prednisolone 5 days (I think) before transfer through to 12 weeks.

[lianm8]

hi! I had high NK cells, was on 10mg of prednisalone a day until 12 weeks, had three intralipids (one just before transfer, one at 8 weeks and one at 12 weeks) and Clexane 40mg daily although this was stopped as I bled. I had failed transfers (2) and miscarriages (4) before this and the three transfers after taken medication for high NK cells have resulted in my 6 year old, 4 year old and I’m currently 17 weeks pregnant with my last embryo! Any questions just ask xx

[Skittles11 in reply to lianm8]

Thank you so much lianm8 I appreciate that you're happy to answer further questions. The thing I'm most interested in is were your NK monitored whilst you were taking the intralipids and steroids? Did you do like a practice where you didn't transfer but the consultant wanted to see if the intalipids were going to work? That's what I had and my cytokines went up. I haven't tried prednisalone though.

Congratulations on your little ones by the way, I'm sorry to learn what you went through prior to that xx

[lianm8 in reply to Skittles11]

no they weren’t monitored. I was just given the medication and it worked for us. I believe that intralipids and steroids work well together (from what I’ve read) so I would definitely look into this. Xx

[minnesota_girl]

Hi Skittles, I'm not sure that doing intralipid without pregnancy tissue present is a valid test for whether it's helping reduce your levels? When they do your tests it should include results from pregnancy tissue tests (like tissue they have in the labs) where they isolate the NK cells and watch how they behave with pregnancy tissue and based on the medicine which impacts. Or at least that's how my doctor explained it to me.

However, regardless of this, I've also had two recurrent loss docs tell me I needed both intralipid and steroid to improve results, not just intralipids or IVIG, and that I&S are basically the best combo for protection...almost have become the "standard" immuno protocol.

I had a transfer with just IVIG after 3 other losses and I had a miscarriage at 7 weeks but my last transfer I had intralipid and steroid (low dose at 10mg) and I'm currently 17 weeks.

I wish you all the best!!

[Millbanks]

Hi Skittles,

I also had prednisolone 25mg along side 3 x Intralipids and this was our silver bullet.

They didn't monitor the levels after taking the meds but it obviously worked as after 5 transfers it was the only one that was successful.

xx

[XOXO13]

Hey,

I was taking dexamethasone before transfer, then I was swapped over to prednisolone for a few days and then swapped back to dexamethasone (I think I was responding better to that drug). I also had intrapilids before transfer, one just after I got my pregnant and then one at 20 weeks as my NK and cytokines were rising again. My NK cells were monitored every three weeks until week 20.

I really feel that the steroids, along with close monitoring and increased blood thinners, helped me fall and stay pregnant.

Wishing you so much luck xx

[minnesota_girl]

Oh yes, and I have also heard that clexane + steroid is used for immuno treatment. I was on clexane also but didn't realise it was for immuno thought it was for clotting issues!