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teacher-ttc - August 10th, 2006 4:03 PM

Dr. Smith,

You have been very helpful over the past few weeks as we initially dealt with slow-growing embryos, and then a possible chemical pregnancy. Well, unfortunately, our hCG levels went from 11 to 16 and back to 12. I know there are various reasons for early miscarriages, but I want to be well prepared when I speak with my RE next week.

You had mentioned being tested for NK cells. I read the information on the link you provided, and did further research on Dr. Beer's website, but am wondering:

1) Are there physical symptoms that might also be indicators of NK cells? (i.e. headaches, chills, sweating, etc.)

2) Would a "poor post-coital" test earlier be an indicator? We had "good" cm and lots of sperm, but none that were moving or alive.

3) Do all RE's have the capability of testing for NK cells?

4) According to the five levels Dr. Beer lists, I noticed the following red flags for my symptoms:
Category 4 - poor post coital test (ASAs)
Category 5 - CD19+5 = slow division, slow rise bHCG
my mom also has fibryomyalgia
Category 5 - per-menstrual spotting, slow division, flu-like symptoms after ET (about seven days later)

5) Can PCO be linked to any of these issues? If so, are there treatments that might help? My RE does not treat my "pco-like tendencies". I ovulate on my own, my insulin/glucose came back fine, but my LH/FSH ratio are reversed.

Thanks again.
Your information and resources are very helpful.
Teacher-ttc

Dr Smith - August 14th, 2006 11:09 AM

A1. Not that I'm aware of, but I could be wrong. The flu-like symptoms after transfer seem plausible, as your body is mounting an immune response to the embryo. The flu -like symptoms (aches and pains) are produced by the interferons that your body releases to combat the infetion. I don't know what role interferon plays in the implantation process. Dr Beer knows a lot about reproductive immunology and seems a reliable source of information. I've just never heard of it.

A2. ASA could be linked to NK cells. What causes the sperm to agglutinate and die in the cervical mucus are IgG or, more rarely, IgA antibodies. However, I must point out that unless you have been specifically tested for ASA (IgG and IgA), the results of an abnormal post coital test are inconclusive. Many other factors can cause a PCT to be abnormal. It is interesting to note that one of the treatments for elevated NK cells is intravenous IgGs. Go figure.

A3. All RE's in the U.S. have the ability to order NK cell tests. The blood samples are drawn in the doctor's office and then shipped to a laboratory that performs the testing (there are a few now). The results are sent back to the RE's office about a week later. The blood samples can be drawn at any time during the cycle.

A4. I think it would be prudent to be tested before persuing further treatment.

A5. Not that I'm aware of. There are many categories of PCOS; some require treament, some not. For this matter, I would trust your RE.

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