Case Report of Successful Pregnancy of a 35 Year Old Woman after 3 RSAs with Targeted Diagnosis and Treatment

A couple (woman 35 years old and husband aged 41) visited our fertility biocenter at 2013 after 2 rapid spontaneous abortions (RSAs) the last two years, while they had a child 5 years old. Both woman and husband were in very good helath without problems.

It was decided for thombophilia testing at April 2014 because the conception was normal, but the embryo appeared to have heart problems at the sixth week. The heart had been stopped after UV testing at the 9th and 10th week without any serious cause.

The following molecular mutations were investigated “Factor V Leiden_G1691A, MTHFR, C677T, fibrinogen-β (-455 G>A),(HPA-1), PAI-1 4G/5G, apoliprotein Ε (Ε2/Ε3/Ε4)” and was found that ALL were heterozygous. The lady was suggested to take a know anti-platelet drug, and later she got pregnant, but the embryo again got on spontaneous abortion for third time. Then, another consultation took place with the couple and NK panel was advised this time.

The results showed that the total NK cells, the endometrial NK cells and the activity of NK cells were ALL high, while the embryotoxicity (ETA) was negative. So, the major reason for RSAs was the NK markers. Because of individual problems, the treatment started at March 2015 for both NK cells and for the thrombophilia.

Then, she performed a pregnancy test, which was positive. Immediately an intravenous dose was administered in order to prevent any RSA for the first trimester, when low molecular weight heparin was added according to her diagnostic testing for thrombophilia. Then, the appropriate prenatal testing was performed from Dr. Papageorgiou Spyros at weeks 12 and 17 and everything was normal.

Conclusion: It has been proven with many report cases and from the international literature that the major reason for women that have RSAs is the increased number of NK cells and their high activity.  For this reason, it is necessary for a safe pregnancy always to check for NK cells and for thrombophilia and first priority for the doctor is to regulate these issue especially at the first trimester to avoid possible RSAs.


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