Today I got my results from the Reproductive Immunology specialist. As i’ve said before, this is quite a new area in recurrent miscarriage treatment and not something which the NHS here in the UK will offer treatment for, so we’re seeing a private specialist.
As a quick recap – we’ve lost three babies in the last two years. The first one happened only about 10 days after a positive pregnancy test, so very early on (but obviously still shit). The second one I saw a fetal pole and sac at 6 weeks, then no heartbeat at 8 weeks, then a heartbeat at 9 weeks (but the baby only measured around 6 weeks), then lost it at around 11 weeks. The third one was very similar to the second one, with slow rising HCG levels and the baby measuring much smaller than it should, even though it had a heartbeat, then lost at about 11-12 weeks too.
All of my results (hormones, chromosome testing, laparoscopy, thyroid) had come back fine previously, so he was going to test me for immune problems and blood clotting problems. I had my tests done last week, and got the results today. Here’s what they found. Forgive me if some of this is very science-y, and also forgive me if I don’t explain it all very well. I’m not a doctor, far from it, I’m just trying to make sense of what he said said!
Natural Killer Cells – count
The doctor we’re seeing believes that many women who have recurrent miscarriages have high levels of Natural Killer Cells. These cells don’t affect people usually, but once a woman becomes pregnant. this ‘foreign body’ (the foetus) is essentially attacked by these cells, so the pregnancy doesn’t survive.
According to our doctor, a normal level would be under 200. My test showed that I had 346. I asked if this was very high and the doctor said ‘its not the highest I’ve ever seen, but its not far off’ – WOW!!!! So this is one area which needs to be addressed.
Natural Killer Cells – ‘aggressiveness’ of the cells
The scientific term is ‘activation’, but I thought ‘aggressiveness’ was easier to understand. Basically they test to see how aggressive the NKC which you have, are. It turns out that although I have a lot of NKC, they are not very aggressive, so that’s good.
TNF (tumour necrosis factor)
This one I don’t understand so much yet, just that it is something linked to my immune system, so I need to go away and do some reading, but ill share it with you anyway.
A normal level is between 13-31, and mine came out at 33.
So – in terms of treatment, this is what happens next (prepare yourself, its a long one!!):
– I carry on with my baby aspirin, metformin and high strength vitamins which I am currently on.
– Next week, I have to have an injection of to bring down my TNF levels. I then have another one in two weeks time. Two weeks after that I have to have my blood tested again to see if it has worked. If it has, we can start trying again (wahoo!) If it hasn’t, I have to have another 2 x injections, and then we can start trying. So best case scenario, we can start trying in my February cycle, worst case March/April (that seems so far off!!! Mustn’t think about that right now!!)
– Once we do start trying, I will need to start taking steroids. This is to, basically, calm down my immune system, so my body doesn’t attack the foetus. If I do fall pregnant, I then have to have an intralipid infusion straightaway, then another one at 8, 12 and 16 weeks. This helps to coat the NKC to prevent them from attacking the foetus.
A lot to take in eh!?!? I certainly thought so!!!
So I don’t really know how I’m feeling right now, its a lot to take in really. I’m definitely pleased that we have been to see this doctor, as it sounds as though I would have continued to lose my babies in future if we’d just kept trying, if the NKC are indeed what is causing me to miscarry. I’m definitely feeling nervous about all the drugs which i’ll have to take and how they will affect me, but I just have to give it a try. I’m also feeling nervous about whether or not this will even work. I want to be positive, but its so bloody difficult when we’ve had so much bad news before.
For now i’m trying to take it one step at a time. Im hoping that the injections are ok and that they bring down my TNF levels so we can start trying in Feb, but i’ll have to wait and see. All the waiting really gets me down, but nothing much I can do about that really.
Time for a bath and a rest after all that I think!