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.
After a certain period of time, we retested again for the 3 markers of NK cells, where the result was really spectacular because with only one dose the levels of endometrial NK cells decreased significantly to about 70% (from 48.6 to 18%). Then, we infused the woman once more with intralipid and informed the couple that they can start trying to conceive nature without the need of IVF or insemination. Also, we suggested to the woman, to take baby aspirin daily. By the end of the summer 2017, the woman informed our center about positive pregnancy test, and immediately she was administered the final dose of intralipid for the regulation of NK cells for the first trimester, and also heparin low molecular weight because of the high PLA.
Today, the pregnant lady escaped the danger of RSA and she runs her 4th month of pregnancy. The pregnancy keeps going on normally up to today without any implications.
Conclusion: Our Center has solved the issue of RSAs in a rate of about 80%, which is very satisfactory in the cases that we handle and we send a very hopeful message to women that suffer from many RSAs, that there is scientific specific solution to their problem, so they don’t have to be looking around for expensive diagnostic tests that most of the time don’t lead anywhere.
The major reason of the selection for publication of this case is on the one hand, the autoimmune problem which was considered by other medical specialties a major issue for pregnancy and RSAs, and on the other hand the huge number of endometrial NK cells, which was the big issue in this case. However, if the retest of the NK panel wasn’t performed by our center, and the correct dosage of intralipid wasn’t administered, the embryo again would have been aborted and the woman would have another RSA. That’s why, the diagnosis and the regulation of NK cells before and during pregnancy MUST be don ONLY by specialized doctors in the sensitive part of reproductive immunology that are able to offer a secure pregnancy to the already prosecuted couple.
