Raised NKA cells

Katie Lou

0 Posts
Reply Raised NKA cells Posted on: Dec 8, 2011 at 7:50pm
Dr Braverman,

My husband has azzospermia meaning our only chance of pregnancy is IVF/ICSI and we are currently going through our third cycle. My two previous cycles failed. Of note is the fact I am also a poor responder. Prior to the cycle with the aim or ruling out other hurdles in our way, I ran three tests - a regular chlamydia test which came back negative, a test for Hidden Chlamydia (using menstrual blood) which came back positive and I treated with antibios and the NK cells test which I was advised to take as there is a history of underactive thyroid in my family tho I have no problems. I got the following:

Total nk cells absolute counts - 369.4 x 10 ( a 6 sits above the 10)/ L
Lymphocytes Total NK percentage - 24.1%
Total NK CD69 absolute counts - 3.43 x 10 (a 6 sits above the 10)/ L
Total NK CD 69 percentage - 0.86

NK cells cytoxicity assay %
NK cell 50:1 - 25%
NK cell 25:1 - 17%
NK cell 12.5: 1 - 12%

NK cell 50:1 with IVIG 12.5 mg/ml - 16%
NK cell 50:1 with IVIG 6.25mg/ml - 18%
NK cell 50:1 with steroid 10mg/l - 12%
NK cell 50: 1 with steroid 5mg/l - 21%
NK cell 50:1 with intralipid 3mg/l - 22%
NK cell 50:1 with intralipid 1.5mg'l - 25%

The doctor advised IVIG at egg collection. I would prefer to take steroids and perhaps intralipids which are less invasive and simply cheaper (I don't think we could afford months of IVIG should I get pregnant). I am currently taking 25mg of prednisolone (from day 7 of stimulation) and plan to do intralipids at collection.

I have 3 questions:
1. I have heard that what happens in the test tube isn't necessarily a reflection of what might happen in my body anyway so I shouldn't get too worried about not taking IVIG. I wondered what your opinion was on that?
2. Do you think that the hidden chlamydia (tested using menstrual blood) may have resulted in my raised NK cells?3. I read a post on your forum suggesting that one dose of IVIG or intralipids is all that is required sometimes. Did I understand that correctly? And how is that decided?

I also take clexane following transfer to thin my blood a little.

Best wishes from London.

Katie

Dr. Braverman

2016 Posts
Re: Raised NKA cells Posted on: Dec 9, 2011 at 7:47pm
Hi katie

you are correct the lab tests for effectiveness of IVIG are of no value.

minimal value of the clamydia test as its a long shot to say this is the reason that your NK is elevated.

Most need more than one IVIG so pred/IL is a better choice.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Katie Lou

0 Posts
Reply Re: Raised NKA cells Posted on: Dec 9, 2011 at 9:55pm
Dr Braverman,

Thank you for your response.

Is 25 mg of prednisolone per day the common dosage in the US? I notice that my assay tests two measurements of steroids and there seemed to be a bigger reduction with the 10mg/l? I wonder if I should be on a higher dose?

Also, putting all my faith in God, when this cycle works, how long does one take prednisolone and intralipids?

Kindest regards,

Katie

Dr. Braverman

2016 Posts
Re: Raised NKA cells Posted on: Dec 9, 2011 at 10:24pm
Im sorry but I see no relevance to the testing in the lab of the effectiveness of the steroids, so I cant comment on your dose. Of course as you increae the dose the better the drug will work.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Katie Lou

0 Posts
Reply Re: Raised NKA cells Posted on: Dec 9, 2011 at 10:40pm
How do you decide what to give patients then, if lab tests are not relevant? Also, what is the usual dose of prednisolone in the US? Thanks, Katie

Dr. Braverman

2016 Posts
Re: Raised NKA cells Posted on: Dec 10, 2011 at 3:10am
You have no choice but to test the patients after the treatment in order to modify the dose, the body is the only "test tube" that can be uses, as there are literally thousands of reactions that take place before a cell gets affected so testing with just one in the lab if just not going to give you any reliable information. I wish I knew who started this, I can tell you that I rarely find a correlation between how the patient responds to a medication and how the "lab" said they would respond.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.