Thoughts on NK cell testing and any recommendations?

[Pinkyflower]

Hi ladies,

I have just had my 2nd ivf cycle which has unfortunately been unsuccessful.

We only have one embryo left so I really want to look at some other options before doing this transfer as my gut instinct tells me something needs looking into. And I don't just want to repeat the same thing in the hope it's just a numbers game.

I have had all the standard NHS tests done but very interested to hear more about NK cell testing, anyone's experience and where you had this done.

Not really sure where to start!

Thank you in advance x

[LouCollier]

Hi

So sorry you are going through this. I had my NK cells tested at Warwick through Tommy Trust. They take a biopsy. the NK cells can be high or low and if they are either they will write you a letter that you can take to your GP or Clinic so that you can get the meds. Mine were high so I was put on steriods for my last cycle (we also moved to DE for this cycle) and I now have 2year old son.

My inbox is always open if you have any questions.

wishing you all the luck xx

[Pinkyflower in reply to LouCollier]

Thank you so much for your reply. So glad to hear you had success with your little boy. I will look up the centre at Warwick. Can I please ask was the biposy painful? x

[LouCollier in reply to Pinkyflower]

It lasted to the count of 10. I personally found it hurt but I know others thought it was more uncomfortable. I don't have any regrets doing it though xx

[Pinkyflower in reply to LouCollier]

Ooohh not too long then! I’m such a wimp haha! Thank you for your help x

[Poop84]

hi i had mines done at crgh we have the endo quartet test so the nk cell biopsy and bloods, vaginal microbiome and testing by for the receptivity for embryo era test.

[Pinkyflower in reply to Poop84]

Thank you for your reply. Did it make any difference to you after having the tests done? x

[Poop84 in reply to Pinkyflower]

Hi yes it did I needed extra progesterone and have inflammation in my cells so need steroids to help sustain a pregnancy.

It is a weird but amazing science. X

[Pinkyflower in reply to Poop84]

So clever isn’t it! Thank you so much for your help x

[Batsford]

Hi Gemmad21,

I would highly recommend the Centre for Reproductive Immunology and pregnancy in Epsom in Surrey. They specialise in NK cell testing and treating recurrent implantation failure and miscarriage. They do very detailed blood tests that test different immune issues such as NKCs and they create a bespoke treatment plan for you. Feel free to DM for more information.

[Pinkyflower in reply to Batsford]

Thank you so much for your reply. I will look this up as Surrey is not far. Was it just the blood tests you had done or biopsy too? x

[Batsford in reply to Pinkyflower]

They just do the blood tests there only, as they believe the uterine biopsy is inaccurate and out of date. I had already had the uterine biopsy with a private surgeon and tested negative for NKCs. Then when I had their blood tests at the CRP my NKC levels were extremely high. I’d done 5 embryo transfers, three with my own eggs and then two with donor egg embryos. The first two failed to implant and the last three resulted in early miscarriage. We went to the CRP as a last resort and they treated me with an immune suppression protocol and it worked. I’m now 31 weeks pregnant 🤞Best of luck.

[Pinkyflower in reply to Batsford]

Oh wow that’s so amazing to read! Huge congratulations to you. Will definitely look into CRP thank you so much x

[JA-fnuk Partner Nurse Fertility Network UK]

For more information about NK cells please take a look at hfea.gov.uk "Immunological tests and treatments for fertility "

Thinking of you

Janet-Partner

[Pinkyflower in reply to JA-fnuk]

Thank you so much for your reply. I have read all the information on the hfea website previously - just looking for any recommendations and experiences really x

[Thierry101]

Hi lovely, I have recently done a full immunology testing, which includes NK cells at ARGC. X

[Pinkyflower in reply to Thierry101]

Thank you so much for your reply. Did you find the testing was all useful to you?x

[Thierry101 in reply to Pinkyflower]

One of the NK levels of mine was ever so slightly raised and so I will need to take steroid tablets to control - but I have done this for my last two failed cycles too.

For peace of mind I have found it helpful as I have just got to rule everything out. Annoyingly all tests we have done have come back in the normal range.

I have had 3 failed transfers, with 5 embryos xx

[Pinkyflower in reply to Thierry101]

Sorry to hear it hasn’t worked out for you yet. I totally understand that though with ruling things out in your mind it’s another box to tick off isn’t it. Wishing you all the best x

[Thierry101 in reply to Pinkyflower]

Yes definitely puts your mind at ease when going into next transfer. We are now about to do the Emma/ Era / Alice tests in the next month and then hopefully October to another transfer.

The last transfer was in April which seems so so long ago now. Sending you loads of love and luck xx

[Pinkyflower in reply to Thierry101]

Wishing you all the best with your upcoming tests and transfer! x

[Doodlebug23]

My clinic did not advocate the tests for various reasons which made sense to me. Instead they put me on a protocol which believe is used anyway. I was on prednisolone and clexane for my last 2 transfers and am now 24 weeks pregnant.

[Pinkyflower in reply to Doodlebug23]

Thank you so much for the reply. This is amazing news, huge congratulations! Can I ask what those medications do and what they are for? Just so it’s something else I can put to our clinic when we have our follow up. X

[Doodlebug23 in reply to Pinkyflower]

It’s called Bondi protocol. Clexane is a blood thinner and prednisolone a steroid. My progesterone levels were always “optimal” before transfer so they didn’t adjust that. They also did a uterine contractions scan to see if it was contracting too much - it wasn’t but they said simple drug before transfer could have been given. I also had embryo glue and an HCG wash x

[Pinkyflower in reply to Doodlebug23]

Thank you so much, that is really helpful! I have seen these medications on the clinics website so it must be something they can offer. Will definitely discuss in our follow up appointment. Wishing you all the best! x

[HedgehogMad]

I don't think the evidence base is there for NK cell or immunological testing - as in there's no robust trials to show that treating it either way is helpful. Plus a lot of the "treatments" for immunological dysfunction are crazy expensive (other than steroids). We had failed implantation of 9 embryos and tried steroids, NK testing and nothing worked. Even Prof Brosens who did the NK test said it's all research based at the moment with no firm evidence.

I'm sorry about the failed transfers, it's a horrible place to be. I'd recommend looking at the ESHRE guidelines for RIF - most of the evidence shows that for the vast majority of women you need to just keep transferring embryos until you find the right one. This is what multiple specialists said to us. Statistically after 3 euploid (tested) embryos there's a 95% chance of live birth. Sending you lots of luck.

eshre.eu/Guidelines-and-Leg...

[Londonlady2024 in reply to HedgehogMad]

I agree and my NHS consultant said that there's no real evidence...even with extra add-ons that I said I would like to try during my last couple of transfers did not have much evidence behind it. I have done both fresh and frozen transfers with add-on which included clexane, aspirin, lubion and prednisolone. My final transfer which was my frozen transfer from the year before stuck in November 2023 and I have a beautiful little boy a month before my 44th birthday. It was a double transfer (day 3). As I only had 3 fertilised, my clinic froze all 3 at pro-nuclei stage (immediate fertilization if below 3). All 3 survived thaw, only 2 by day 3 and they were both transferred. In total prior to my frozen transfer, I have had 4 fresh transfers. I was a very good responder to meds so I feel all the hormones probably also affected implantation.