I can tell you how I measure this immunological reaction and changes when I’ve been working in the UK. I learned about the immune system through some specific tests that professor Alan Beer developed in Chicago many many years ago. He was one of the pioneers in the world who firstly spoke about the immunological problems during pregnancy. So Dr Beer developed some tests in order to count various parts of the immune system. Those tests are very reliable, very difficult technical tests but are reliable. In order for you to understand the changes in the subpopulations into the blood, those tests are quite expensive and are tests that are not easy to be done in order to monitor as close you need the immune system so, by dealing with all those things, I try to develop a method to do this monitoring with a very simple mainly blood test which is the FBC (the full blood count) in order to monitor changes in the subpopulation but not specific to this, to the natural killer, to the CD53, to the CD19 cells but all those together they create a family that you can see those changes in the full blood count. By doing this simple monitoring, because this is a very simple monitoring, by doing this simple monitoring and combining it with the reports of the woman, even daily it is necessary, I believe that I can manage almost 95% of the immunological reactions.
Some clinics offer tests to look at the specialised uterine Natural Killer cells. The lining of the uterus, the endometrium, changes over the menstrual cycle. These changes prepare the endometrium for implantation. If implantation does not occur, then menstruation follows at the end of the cycle. An increase in the number of uterine NK cells after ovulation is a natural component of these changes. Tests to study the endometrium are invasive and frequent biopsies are needed. It is also difficult to accurately count Natural Killer cells and it is unknown whether numbers reflect how the Natural Killer
cells function. Because of all these uncertainties, biopsies to assess the state of the endometrium should only be offered in a research setting.
For women, besides innovatieve and exceptional quality status of NK cells – three markes that I have mentioned before, two other markers that we check are: “embryo toxicity” and “blocking factors” – we check them from the serum of the lady, the level of the embryo toxins and blocking factors – that means if the results is negative because the reference is positive, then it has to be histocompatilbility with the husband – that means that there might be no pregnancy for many years and even the miscarriages for the rest of their life. It is the case when the couple is like relatives – they match so much together – it is very difficult for them because even if they perform many IVF, they might never have a successful pregnancy or healthy baby.
Let me please refer to embryo toxicity because it is a very specific test that so far statistically, we have seen that 1 out of 4 ladies – which is 25% that are positive to embryo toxicity, even if they do hundred IVF trials, will never have a successful pregnancy.
That is very important because today for example, I have a patient only 28 years old and she was told that she needs to do IVF because for 3 years she never succeeded in getting pregnant with her husband. She is positive in embryo toxins and she also has a blocking factor with husband. The only solution in such cases is infusion of IVIG, there is specific bibliografi that IVIG in the two hours of infusion – it is long lasting infusion so the patient needs to be patient – releases the patient from embryo toxicity, dissolves these blocking factors. That means – it gives a chance to go. Duration is 8 months to 1 year with one infusion only. That means it gives the couple a chance to have a successful pregnancy whether the lady will go to natural conception or IVF trial.
We have many successful pregnancies, we have many healthy babies – at least the last 10 years when I am doing it professionally. People come from NIgeria, UK Germany and we have had success with couples that had more than 5 IVF trials so these two diagnostic markers are very important. They are covered with NK cells, the 80% the immune status of the lady. I say 80% because as members of the International Society of Reproductive Immunology, we are missing 20% to be 100% sure that we know the immune status of the lady. We lack the 20% but next I don’t know how many years, I think we will be much more comfortable with the immune status of the lady if we don’t have any genetic status. We have to admit that we avoid any genetic status and we concentrate only in immune status of the lady, then we will be 100% sure that we will regulate the immune status for the lady in 99, 99% and now we say we have high chances but we cannot say the specific number because we say scientifically the truth, I mean we do not make miracles. Miracles will come themselves by just the analysis and sciences.
