Quick Q on autoimmune factor testing
3 Replies
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Hello Doctors! Quick "almost-yes-or-no" question:
From everything I've read, it seems that those who are better served by being tested for autoimmune factors and NK killers are those who don't even reach a chemical pregnancy, correct? Meaning... if you got it to implant, then it ain't about the rejection of the embryo.
Do I have that remotely right? Should I not waste time/money on these types of tests if I had a chemical pregnancy?
Thanks for your time and patience with all of us on this wonderful forum!
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Oh oh... quick follow-up. I have just read something to make me believe my above assumptions about "if they implant, it isn't autoimmune factor nor NK killer."
Seems these factors can also cause miscarriages, which means the embryo HAD to implant.
Hm... okay, then. Followup question is: why not go ahead and treat (without testing) for these autoimmune/NK killer/etc. factors before embryo transfer? Is there any harm in doing so?
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This is more of a clinical question, but I'll put in my two cents worth before passing it off to Dr. Miller.
From what we know or think at this time, elevated NK cells and/or abnormal activation of NK cells can come into play at several junctures in reproduction:
1. Attacking the embryo and preventing the embryo from getting even a small toehold in the endometrium (never been pregnant)
2. Attack and prevent the implanting embryo from continuing to develop beyond 2-3 weeks (chemical pregnancy).
3. Attacking nd preventing the fetus from continued growth through the first trimester (recurrent miscarriage).
NK cells are necesary, but nasty little buggers which, given the chance, can play havoc with implantation and pregnancy.
With regard to treatment options, Dr. Miller's the expert. I defer to her.
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Well than you , Dr. Smith, your 2 cents were more like 2K - Very succinct - nothing to add to. Zoe's question is a good one - why not just treat? Why not just treat everyone?! Sometimes it's tempting but that would just be "overkill". With any treatment one must weigh risks against benefits. IVIG (the treatment for excess or overactive NK cells) has helped innumerable people get px. and retain pregnancies but it is expensive, invasive, and, in some cases, induces side effects that are uncomfortable and counterproductive. Then too, there are those who criticize it's use and, although we have seen its positive effects time and time again, when we suggest this therapy to patients we do tell them this and add that many still consider it experimental.
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