Immune Treatment

Here at Cyprus HOPE IVF Consultation we can help patients who require a natural killer cell activity   blood test. Testing for NK Cell activity involves a simple blood test to measure the number and activation levels of the NK cells. The blood test can be performed at any stage of a woman’s monthly cycle as an alternative to, or in conjunction with, a traditional endometrial biopsy of the uterus.

There are several factors that can cause embryo implantation to fail, including:

• Genetic causes
• Anatomical causes
• Endocrine causes
• Haematologic causes
• Immunologic causes

In some cases, it is the result of a chromosomal abnormality (known as aneuploidy) within the embryo. In some cases, it can be a combination of the above causes. In the past decade, there has been considerable efforts and research trying to identify possible immunologic causes for poor fertility treatment outcome.

What happens around implantation?

The embryo is formed of two cell lines (the inner cell mass and the trophectoderm). The inner cell mass contains the cells that form the baby and the trophectoderm contains the cells that will form the foetal part of the placenta.  Implantation is a complex process that involves interaction between the trophectoderm and the womb lining (endometrium). During this process there is mutual exchange of substances and chemicals. This is sometimes referred to as ‘embryo-maternal cross talking’. Successful implantation is the first crucial step in achieving a pregnancy.

What do I need to know about Natural Killer cells (NK cells)?

NK cells are immune cells that belong to a subcategory of white blood cells called ‘Lymphocytes’. They provide the body with protection against virally infected cells and potential cancerous cells. NK cells are produced by the bone marrow and then they move to the blood circulation to play a role in the body natural defence mechanisms. Some of the NK cells will migrate to various organs including gastrointestinal tract, liver and the uterus where they undergo specific changes that render them as one of the immunological defence barriers in those tissues. In the uterine lining after ovulation and in early stages of pregnancy; NK cells account for more than 80% of the white blood cell population. NK cells produce and respond to a variety of chemical substances called ‘cytokines.

Treatments – Immunotherapy

One of the missed diagnoses for recurrent implantation failure and recurrent early pregnancy loss is an underlying female immune system disorder that targets the embryo as a foreign invader. Normally, the embryo makes itself invisible to the body’s Natural Killer cells (N-K Cells) so it does not get destroyed by those cells. Unfortunately, some individuals have overactive killer cells that recognize the embryo as a foreign invader, resulting in recurrent failed implantation or recurrent early pregnancy loss. Patients with overactive NK cells can benefit from immunotherapy with intralipids or IVIg (Intravenous immunoglobulin-g) and oral steroid treatment amongst others.

Here at Cyprus HOPE IVF Consultation we can help answer any questions you may have concerning NK cell-testing and immunotherapy.