The Role of Immunological Tests and the Therapeutic Approach for Successful Pregnancy after 12 Failed IVFs in a Case Report of a 48 Year Old Woman

A couple (woman 48 years old and husband 60 years old) came to our Fertility biocenter in the beginning of 2015 seeking for help because of the disappointment they had after at least 12 failed IVFs in different famous clinics. In all these attempts, the couple NEVER succeeded a pregnancy. The woman was subjected under two surgeries (one for fibrous tissue and one for the salpinxes) and the laboratorial tests performed for thrombophilia were heterozygous at MTHFR and at V-Leiden factor, while the test Prothrombin G20210Α was normal. On the other hand, Husband’s general health condition was without any problems.

After a long discussion about woman’s medical history about the psychological pressure that she lived after so many years of trials in IVFs, they decided to perform immunological tests and the marker PLA (platelet leukocyte aggregates), which is very important and additional to the classical thrombophilia panel.

The results of the immunological tests showed that the number of NK cells in the endometrium was VERY HIGH (3 times higher than the normal one), while the NK activity and PLA were increased and the embryotoxicity (ETA) was normal.

In the next consultation, the results and evaluation were reported to the couple and the therapeutic protocol that must be followed in order the NK activity and the NK number to be regulated. These two diagnostic markers are totally different and have peculiarities in terms of the therapeutic approach. By these tests, we could explain in a statistic range of 80% why IVF trials failed all the past years. Also, we suggested the administration of biological supplement intravenously, and then we just rechecked the NK markers after 3 weeks because of the high percentage and activity of these cells and the low response of the woman to the supplement.

In the next consultation, the endometrial NK cells were rechecked and the woman mentioned to her gynecologist about this NK diagnostic tests. He tried to persuade the woman not to do the NK testing despite the fact of the so many IVF failures that she had. The results of the retest were perfect and we encouraged her to advance to a programmed IVF trial under certain conditions. She was very well prepared by the administration of the biological supplement, baby aspirin, and low molecular weight heparin and methylated form of folic acid because of the MHTFR mutation that she had and that is the only form that can be absorbed by the organism.

The IVF trial was performed by transfer to 3 embryos and for a good surprise for the first time in her life the β-hCG was positive, which gave her first pregnancy. Also, intravenous therapy was given again so the regulation of NK cells can be achieved for the first trimester and to avoid any possible rapid spontaneous abortions. The surprise of this result was not as MUCH surprise as could be considered because the diagnostic and therapeutic approach of our Fertility Biocenter in failed IVFs reaches about 70 to 80%, which brings it to one of the most trustworthy centers in reproductive medicine.

Conclusion: The immunologic investigation individually and on target in diagnostic as well as in therapeutic level EXISTS, IS APPLICABLE, HAS RESULTS, HAS LOW COST, and can help couple to go to IVF trials with much better chances. All these approaches have been tested and applied for the last 30 years by the most experienced American professors specialized in reproductive immunology and at least young gynecologists and IVF centers must be informed about our professional scientific approach, so women MOSTLY won’t get prosecuted psychologically and mentally, so the couple can have the desirable result with the lowest cost.

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