PCOS & NK Cells

Rachel

1 Posts
Reply Posted on: Jul 8, 2014 at 9:35am
Dear Dr. Braverman,

Hello, my name is Rachel and I am 34 years old.
I have 4 x Repeated IVF Failures.
I have PCOS (with egg immaturity issues), and High NK Cells (CD 56).

I am planning to do our 3rd FET in August this year and would really appreciate your advice / second opinion.

My husband has been tested and he has no issues.
We fell pregnant naturally in 2009 but I miscarried at 8 weeks.
We have now done 4 IVF cycles over the past 4 years.

I experienced OHSS during my 1st IVF cycle and they retrieved over 30 eggs but all were immature and could not be fertilised.

The 2nd IVF cycle resulted in 9 eggs but all were still immature. We were told by that IVF clinic that we would never be able to conceive a child of our own.

It was then that we learned about In-Vitro Maturation (IVM) and found a different clinic willing to perform this form of treatment. We completed our 3rd IVF cycle, which resulted in immature eggs again however this time they were able to mature my eggs in the lab and then fertilise with ICSI, and we got 5 embryos frozen at Day 3.

We did two FET’s (transferring 2 embryos on one occasion and 3 on another), but nothing.

It was then that we learned about Reproductive Immunology and I had myself tested.

I have now been told that I have HIGH levels of NK Cells (i.e., CD 56), and Borderline Levels of CD 57.

I have also been diagnosed with PCOS and have high Testosterone and Androgen Levels however my cycles are a regular 30-31 days and I am a healthy weight with no other typical PCOS symptoms. I have been told I have a high ovarian egg reserve.

I have a history of inflammatory bowel disorder and a family history of various autoimmune disorders / issues.

I am now seeing a Reproductive Immunologist who has had me on Metformin XR 2000mg, Co-Q10 Supplements, Vitamin E, Inositol, L-glutamine and L-arganine, for the past 6 months.

I had my 4th cycle of IVF in May this year and they retrieved 30+ eggs again, all still immature, but again performed IVM and we end up with 4 embryos, 7 cells, frozen at Day 3. The Embryologist said these embryos looked to be better quality than the last lot, but still no way of knowing for sure.

We have tried both Agonist and Ant-agonist, slow long down-regulation IVF protocols now but always seem to get immature eggs?

My Reproductive Immunologist’s plan for my next FET is Dexamethasone 0.5mg, Clexane 40mg, Progesterone Pessaries 400g, and Intralipids.

I would really appreciate your advice or any other suggestions that you may have regarding my infertility issues or treatment plan.

Do you think I should just transfer 1 embryo at a time?

And do you think I should do IVIg or just try Intralipids first?

Dr. Braverman

2027 Posts
RE: PCOS & NK Cells Posted on: Jul 8, 2014 at 9:45am
I think you need to call me . Fill out the consult form on our website and we will schedule a free 10 minute consultation.
As you know if you have read our website that PCOS can cause significant inflammatory changes and lead to pregnancy failures. The testing you have had done is not adequate to correctly assess the situation . I do agree wtih the Metformin and dose. But you may requre more significant immune therapy than what you have been prescribed.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.