Case Report of Successful Pregnancy of 35 year old lady with Autoimmune Disease after 4 RSAs

endometrial NK cells

"Α 35 year old woman with her husband came to our center with her husband while she had 4 rapid spontaneous abortions (RSAs) the last 2 years and she was seeking the reasons of losing her embryos in  the 5th(two), in the 6th(one), and in the 7th(one) week of gestation. The couple already had a girl 3 years old, and after the first birth, she lady suffered from an autoimmune disease and she was under drug therapy with PLAQUENIL.

The first thing we had to clarify was to investigate the woman’s quality of eggs. So, initially AMH was measured, which was in good levels, so we didn’t have to measure  inhibin B for the quality of her genetic material.

The second thing we had to do is clarify that husband’s (37 years old) sperm was ok. We ran a sperm analysis, and DNA fragmentation, which was 6% and means excellent quality.  Also, we tested woman’s TSH and Vitamin D3, which were normal.

So, our investigation was focused in woman’s immune system.  We measured total NK cells, endometrial NK cells, NK activity, Embyotoxicity (ETA), and platelet leucocyte aggregates (PLA, special thrombophilia biomarker).  The results showed that levels of endometrial NK cells were very high (48,6%), three times more than the normal ranges, while the NK activity was slightly increased, and therefore the pregnancy results would be blocked for sure. ETA was negative, while PLA was 3 times higher than the normal ranges. The levels of endometrial NK cells were one of the highest that we have seen until now in laboratorial level, and we concluded that it was the major cause for the 4 RSAs. Our center administered targeted intravenous infusion of 20% intralipid depending on the diagnosis..."

Learn more:

http://fertility-biocenter.com/case-report-of-successful-pregnancy-of-35-year-old-lady-with-autoimmune-disease-after-4-rsas-rapid-spontaneous-abortions-1660

 

Case report of two successful pregnancies in the row after 3 RSAs, while they had one child

"A couple visited our center (woman aged 37 and husband 43 visited our center at 2013 while they had 2 RSAs the last two years, and they had a child 5 years old. Tests for thrombophilia were performed ((Leiden_G1691A),  (MTHFR, C677T), (MTHFR, A1298C), plasminogen-β (-455 G>A),(HPA-1), (PAI-1 4G/5G), Apoliprotein Ε (Ε2/Ε3/Ε4). All those tests showed heterozygous and the lady was suggested to take know anti-platelet therapy.

In the next three months there was positive pregnancy, but RSA was occurred for the third time and therefore a new meeting was set with the couple to test for NK cells (total and endometrial, NK activity, and ETA (embryotoxicity). ALL NK markers were not normal, but ETA was OK.  So, the major cause of the problem of RSAs was NK cells. Soya oil emulsion dose targeted for the lady was infused intravenously and anti-platelet therapy was administered orally. 

Later at October 2016 had a pregnancy positive test and this time avoided RSA after the supervision of Dr. Papageorgiou Spyros and she had another dosage of soya oil emulsion until the 3 month of gestation to avoid the RSA because of NK cells. At the 17th week, amniocentesis was performed and karyotype was normal and since then pregnancy went under normal conditions.

Conclusion: International literature has shown in many cases the women that have RSAs may be because of thrombophilia or the biggest reason the NK levels, or endometrial NK, or the NK activity. For these reasons, it is necessary to test for thrombophilia all NK markers in order to have regulated the immune response of the woman before and during the pregnancy."

Source

Lack of stem cells to blame for recurrent miscarriages

via medicalschool.tumbler.com

"Scientists at the University of Warwick have discovered that a lack of stem cells in the womb lining is causing thousands of women to suffer from recurrent miscarriages.

The academics behind the breakthrough are now to start research into a treatment which they believe could bring hope to those who have suffered failed pregnancies.

Professor of Obstetrics & Gynaecology, Jan Brosens led the team who unearthed the link between stem cells and miscarriage. He said: "We have discovered that the lining of the womb in the recurrent miscarriage patients we studied is already defective before pregnancy.

"I can envisage that we will be able to correct these defects before the patient tries to achieve another pregnancy. In fact, this may be the only way to really prevent miscarriages in these cases."

The team found a shortfall of stem cells is the likely cause of accelerated ageing of the lining of the womb which results in the failure of some pregnancies.

Miscarriage is the most common cause of loss; between 15-25% of pregnancies end in miscarriage and one in 100 women trying to conceive suffer recurrent miscarriages, defined as the loss of three or more consecutive pregnancies..."

Learn ore here:
http://medicalxpress.com/news/2016-03-lack-stem-cells-blame-recurrent.html

Making sense of a miscarriage

via todaychristianwoman.com

"..Miscarriages are so common – one in five pregnancies end up in a miscarriage," says Arri Coomarasamy, a professor of gynaecology at the University of Birmingham. Empathy is soothingly evident in his voice as I come to the end of my story.

The one in five figure is often quoted. Sometimes it creeps up to one in four. This is because it's difficult to determine how many miscarriages take place. In the UK, miscarriage means the loss of a pregnancy during the first 23 weeks (any later and it is called stillbirth). But it often occurs before a woman even realises she's pregnant, and most of the time – 85 per cent – it is in the first 12 weeks of pregnancy.

That has given us clear social guidelines. The "12-week rule" warns against telling anyone you're pregnant until the end of the third month. It anticipates the risk of loss, even sets us up to tentatively expect miscarriage during the early stages of pregnancy, but this silence doesn't make it any easier if it does happen.

A recent survey of over 6,000 women who had had a miscarriage, conducted by the charity Tommy's, found that around two-thirds found it hard to talk about. The same number felt that they couldn't discuss their miscarriage with their best friend. A third didn't feel that they could even talk to the father about it..."

Read the whole article here:
http://medicalxpress.com/news/2016-03-miscarriage.html

NK Activated Cells in Infertility

The Role of NK Activated Cells in Infertility, RSAs, and Failed IVFs

"The number and the activation of the NK cells are the different markers, but very important for the reproductive infertility issue in terms of infertility, RSAs, and failed IVFs. Natural Killer (NK) cells are a lymphocyte subset that express CD56+ on their cell surface. They are large granular lymphocytes that arise from the bone marrow and circulate peripherally before localizing to specific tissues. NK cells are the most prevalent lymphocyte population in secretory endometrium and in decidua of early pregnancy. They are believed to play a role in regulating trophoblastic cell migration.

The NK cell activation assay tests the killing function of circulating NK cells as well as the ability of interleukin-2 (IL2) to stimulate and intravenous immunoglobulin (IVIg) to suppress that activity. NK activity can be measured as a bioassay that determines the ability of activated NK cells to kill their target (K562 cell line)..."

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