Posted by on June 11, 19100 at 10:34:11:
In Reply to: NK Cells - Question for a Doc. or anybody who knows posted by Nanu on June 10, 19100 at 20:36:23:
Nanu,
We are all searching for the magic that will make our next attempt a success. This search often leads us in directions that are unknown. It is tempting to use medical ideas just because they sound "good". Unfortunately, many of these ideas have been put in practice without a sound body of medical evidence to support them.
NK cell testing is one of the areas that have been brought into practice without the benefit of proof. No doctor can tell you, based on evidence, what the results of any NK cell testing mean. No doctor can tell you, based on evidence, what treatment you should undergo bsed on yourtest results. This is because no evidence exists.
NK cell testing has been used for many years without critical analysis. If you undergo NK cell testing you are participating in an uncontrolled experiment.
Having said all that, practices that have a major focus on pregnancy loss and recurrent abortion will offer this type of testing. They usually send the blood out to a lab outside of New York.
The real answer is that we know very little of why one embryo will implant and another will not. Sometimes it's just a matter of time. Someday we may know how immunological issues like NK cell testing fits into this picture. The answer will require organized research and funding. I believe it is unfair to patients to promulgate the myth that we already have the anwers... when we don't.
The most recent entry in the literature was in the March 2000 Fertility and Sterility pp 536- 540, "Successful treatment of immunologic abortion with low-dose intravenous immunoglobulin" by Stricker et al. In this paper they noted 47 women with an average of 3.7 miscarriages. The patients ages were between 28 and 45. Forty per cent had incresed NK cells. Thirty six underwent treatment with IVIG within two weeks of attempted conception. IVIG treatmetn was continued for some of the patients who concieved. Twenty four concieved and nineteen (79%) delivered. Eleven patients patients "refused" treatment, seven (63%) concieved but all miscarried in the first trimester. Three (8.8%) women had adverse reactions to the IVIG.
The authors state that there was no difference between the women who shose treatment and those who did not, but they did not publish provide the information of age, number of abortions and immunological testing between the two groups. A statement of no difference is not sufficient for us to interpret this data. The best way to prove the effecacy of IVIG would have been to randomly assign women to treatment or placebo. We don't know why one group chose to be treated and the other did not... that is the difference between them. WE don't know what the post conception care (except for the IVIG) was between the two groups, that is another diffference between them.
This is a story, not an experiment. It still leaves us in the dark. We don't deserve to be there. You don't deserve to be there. IVIG is expensive and your hopes and dreams are precious. Close to nine percent of the women who used IVIG in this study had adverse reactions, that's a lot of trouble for an unknown gain. The pregnancy rate and miscarriage rate in the treated group was no different than would be expected based on chance. The implantation rate in the untreated group was not different from the treated.
Sorry for the rant... this issue gets me going.
Hope this discussion was helpful.
Dr. Barad
: Does any body know who does NK cell testing in Manhattan. Does it affect implantation ? Can they cause ectopics ?