Low uterine NK cells( any success stories?)

[Wants2bhappymumma]

Hi all,

I have 5 losses (4 MMC,1 spontaneous,$ naturally conceived and 1 top quality embryo transfer via IVF).Following y 5th lost I had a consultation with Prof Brosens at Coventry Implantation clinic and I was advised to go for Uterine biopsy for NK cell testing.The first one came back a low (1.27%).I was wondering whether any of you have any success story after being diagnosed with low NK cell.All my my losses were early loses, 4 of them between 7-8 weeks and the IVF one was at 5w5D. I never had problem with getting pregnant.

I will probably go for the second biopsy if I don't get pregnant in this cycle 😜.
Anyone willing to share their experiences ?

@Wonderwal thank you for sharing this and your results. I tried not to get bogged down with detail amd just looked at the overall picture. I guess the difference between our results is that I am showing high on both the inflammatory markers in the bloods hence consultants logic to use both intralipd and steroid. Spoke to Mr O and he feels that sometimes they have been too cautious with using just intralipid. I think the overall message was that they focus more on nk markers that are high rather than those that are low but they also admit that there is no definitive answer. I guess in reality this is still somewhat experimental. I will be having embryo glue. I asked about hcg today and was told it is typically offered when the nk biopsy shows need for it.

@Prayformiracles glad you have been able to make a decision you understand and are happy with! That’s the main thing I think!
Best of luck with your transfer, I really really hope for you that it is successful 🙂

@Wonderwal tbh I'm not sure I have made a decision but I better understand Mr O's decision-process-making so more inclined to follow that advice now. Still need to get comfortable with it though. Thank you for your best wishes.
Last attempt. So whatever happens the 6 year ivf journey is soon coming to an end.

@Prayformiracles Hi I know this is an old thread but I wondered what you decided to do for your final protocol, in terms of taking steroids or not, and whether you were successful?
I am in the same position as you were, I’m on my final ever transfer (after an 8 year ivf journey) with high NK cells in my bloods but one low marker in my uterine (gmbz). One dr has advised not to start steroids until a positive test and another has advised to start them before the transfer to address the high NK cells in my bloods.
i am very unsure what to do and I’m trying to learn from others experiences, who are in the same situation.
I would be so grateful if you wouldn’t mind sharing your final decision and the outcome.
Many thanks x

@PositiveThinkerAlways my October cycle did not go ahead but I'm close now. I decided to take my consultants advice and I will be starting steroids and intralipid next week. I feel peaceful with this decision now. I have spoken to some other professionals eg. Acupuncturist and nutritionist who say they have seen success with it. That's not to say it works for everyone on these treatments as we know all too well.
When I spoke to consultant he said there had been times in the past that he had regretted not taking a stronger approach (e.g. i think the steroid treatment) but he also admits maybe he remembers most the times that didn't work.
Obviously I don't know what the outcome will be. But do what you feel most peaceful to not have regrets I think.

I have also had conflicting advice about how long to use vaginal probiotics for before fet. Consultant says til last day and my nutritionist who has supported me with microbiome for several months has told me to stop 2 weeks before fet. I was stuck on this too but had to make a decision and decided to stop approx 10 days before fet is due. Hopefully the oral probiotics are still doing a good job.

Good luck 🙏

@Prayformiracles Thank you SO much for your swift response and sharing your experience. I think I am leaning towards taking the steroids as well and hoping for the best. I’ve wrangled with the decision for so long so it’s super helpful to hear from someone else in the same situation. It’s great you are at peace with your decision .

In case it helps, I’ve usually used vaginal probiotics up to the day before transfer and have been pregnant twice using this approach but I have heard from many women who have stopped a week or so before transfer and also got pregnant so I would think as long as the microbiome is in a good place beforehand, it isn’t essential to continue right up to transfer. And the oral probiotics should help maintain the healthy microbiome over this period until you restart them again.

Wishing you lots of luck with your upcoming transfer and hoping for success for both of us this month!! x

@PositiveThinkerAlways
Glad you have made your decision too.
I'm not yet peaceful about the vaginal probiotic thing. I want to keep using it but I also want to trust my nutritionist. She says she has seen many times before situations where progynova causes thrush and then balance activ and vaginal probiotics can make it worse. And if that happened I'd probably be kicking myself for not listening to her. On the other hand when I take vaginal probiotics it makes me feel like I'm maintaining the best possible environment down there. Maybe I have done enough already and taking another weeks worth won't make a difference now. Who knows.
I don't even know when I would restart vaginal probiotics after fet because progynova continues also.
If you have also used progynova, Have you ever not taken vaginal probiotics right up til the end and wish you had?
Thanks and good luck too x

It’s so hard isn’t it as there are so many decisions to make a lot is at stake!
I use the oestrogen patches and never had thrush while using them so have always continued with probiotics, but I would definitely take the advice of an expert that you trust. I really believe the oral probiotics do a good job of maintaining the microbiome once you have it in a good place. I know there are strips you can buy that measure the ph of the vagina and if that is where it should be then it indicates your vaginal microbiome is not compromised eg with BV or another bacteria. Maybe that would give you peace of mind? X

@PositiveThinkerAlways I almost think that any more testing now could be detrimental because if I see something not quite right it will make me worry sick and its too far along now. I don't think I have had thrush with the progynova before either but I guess can't assume it could never happen either.
Yes it's just so hard making these decisions when you hear mixed advice - all from professionals. Actually another doctor from the fertility clinic also happened to mention stopping balance activ (not sure about probiotic) unless there's a reason. Hopefully you are right and that the oral probiotics maintain everything anyway. Fingers crossed and praying it will all work out. 🙏

Hi does anyone know lots about endometrial lining. When it gets to 8mm or over I am usually told to start progesterone the next day. This time I have been told they are too busy and therefore to start it in two days time. I know thick is good but I think I also read somewhere that if it gets over 10mm it's sub-optimal. I'm just a bit worried if it reaches 10+ by the time I start progesterone.

@Prayformiracles Yes I agree that too much testing isn’t good for your mental health and you have to draw a line under it and crack on with your protocol so if it helps, I think you are doing the right thing.
8mm is a great place to be and I’m sure the clinic wouldn’t ask you to delay starting progesterone if they weren’t confident you had a bit of wriggle room. To be honest I struggle with a thin lining so I haven’t experienced this before - I would be delighted if mine was at 8mm by day 14. Hopefully someone else will be able to advise you better but wanted to wish you lots of luck on this cycle.

@PositiveThinkerAlways and @Prayformiracles I am in your exact situation just a year and a half later. I was wondering how you both got on with the steroids and intralipids for your final FETs? I really hope you both had success but have also been on this journey long enough (6 years) to know that not all of us will get our happy ending. Any update from either of you would be much appreciated. Many thanks.

@VioletHaze24 unfortunately my final cycle was not successful and due to our age we decided to draw a line under our 9 year journey. I am sorry not to be able to share a positive, success story with you but I am probably in the minority as I think most people do actually achieve success when the right protocol etc is found. Wishing you all the best in your situation and genuinely hope it works out well for you.

Thank you for your response. I know it’s been a while since this thread was active so I really appreciate you getting back to me. I’m truly sorry to hear that @PositiveThinkerAlways 😓 It’s such a mentally and emotionally exhausting journey. I hope you’ve made peace with your decision as it’s such a tough one to make. Did the doctors give you any feedback on why it might not have worked with the immune protocol? I think I spent about 8 hours yesterday trawling through fertility forums, instagram and mumsnet to see if I could find any information about what has worked for others or to find something we haven’t tried yet. I think it’ll be the end of the road for us too after this transfer due to age as well. It really is the club that nobody wants to be in. Thank you again for getting in touch. I’m so very sorry it wasn’t the ending you wanted 😢