Age, Recurrent Miscarriage and Natural Killer Cells

Ez - posted on 10/25/2009 ( 6 moms have responded )

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I watched a current affairs program tonight on some new research being done into the causes of recurrent miscarriage. The following is taken from the IVF Australia website:

http://www.ivf.com.au/IVF-Latest-News/ro...

In the case of recurrent miscarriage, a cause can only be established in about 50% of cases.
Fertility specialist with IVFAustralia, Dr Gavin Sacks, is researching what role, if any, Natural Killer Cells have in unexplained recurrent miscarriage.

Natural Killer Cells are white blood cells which are produced by the body to fight infection.
Through Dr Sacks research, he estimates that around 15% of women with unexplained recurrent miscarriage have higher than usual levels of Natural Killer Cells in their uterus.

Dr Sacks, together with scientists and pathologists at St George Public Hospital in Sydney, has developed a simple blood test that measures the level of Natural Killer Cells in the uterus of pregnant women. Higher than usual levels of Natural Killer Cells in the blood and uterus can be treated with a simple steroid tablet which will suppress the body’s immune system. Such treatment may prevent miscarriage, and help a woman to achieve a full term pregnancy.

Now that a test has been developed to measure Natural Killer Cell levels, Dr Sacks plans to establish a large clinical trial to determine the effectiveness of suppressing the immune system in women with high levels of Natural Killer Cells to prevent miscarriage. The results of such a trial may not be known for a number of years.

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The story showed one couple who went through 20 miscarriages with undetermined cause before having this steroid treatment and finally managing two full-term pregnancies. While their perseverance obviously paid off, I honestly can't imagine going through that many losses and still trying.

The other issue that came out of this story for me was the impact maternal age has on recurrent miscarriage. The two other examples were both of increased maternal age. One was 41 and had suffered two miscarriages after delaying starting a family. She was (naturally) devastated, but said she put it off so she could experience life and now felt she was better equipped to be a mother.

The other was 39, had suffered three miscarriages, and regrets leaving it so long, despite now being 4 months pregnant (the furthest she's ever made it). She explained that despite keeping healthy in every other way, her eggs were still 39 years old, and she simply didn't foresee this being a problem for her when she was in her 20s.

So I guess my questions are....

Can you imagine continuing in a quest for a baby after 10, 15 or 20 miscarriages? Or would the stress simply be too much?

Does this new technology regarding Natural Killer Cells seem as exciting to all of you as it does me? The idea that a simple blood test can show a likelihood of miscarriage (due only to this problem ofcourse - not due to congenital abnormalities) seems almost too good to be true for women with ongoing fertility issues.

And can a woman who chooses to delay having a baby til later (ie, late 30s and onwards) really be surprised if things don't go according to plan? Now I'm in no way implying that their grief should be any less, or that they should necessarily choose to start trying for a baby sooner. But we know chances for problems in pregnancy increase dramatically with age, so I guess I was just a bit surprised that women are still putting it off til later, only to then turn around and be shocked when those problems do indeed happen. And I'd also like to add I'm not talking about women who have struggled with infertility for years and finally succeed later in life. The women in the story specifically said they INTENDED to wait.

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Quoting Sharon:

To me its not a miscarriage until you're more than 2 months along. Things went wrong and your body fixed it.



I have to say I am put off by your comment.  As someone who experienced multiple miscarriages, a confirmed pregnancy IS a pregnancy whether you are under or over 8 weeks.  An implanted fertilized egg in itself is something that many women who experience infertility issues strive for, and then secondly, get that fertilized egg to remain viable in order to develop into a growing fetus/embryo.  So if I understand your comment, my early miscarriages that were under 8 weeks, and confirmed by my fertility doctor, were not really anything?  My medical records would prove otherwise AND showed my patterns of early 1st trimester loss.   It was not until I became pregnant again that my doctor was able to determine the cause of the miscarriages and medically fix it.



 



I can relate to women who try month after month after month.  After only 3 years, we gave up and began to pursue adoption.  I know my own body's physical and mental limits.  But I know women who have been going strong at trying for up to 10 years.  So I have to say it is hurtful to downplay a miscarriage as if it's no big deal under 8 weeks.  There are so many women who would have begged their bodies to at least make it that long.



 



In response to finding a potential cause, I think it is fabulous.  In response to advanced maternal age and infertility, I believe that there are some women who are in la-la land because they are not educated in their fertility and reproductive systems.  Some women-certainly not all.  I met some great women going through infertility at an advanced age (over 35) and most of them seem to understand their struggles.

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Ez - posted on 10/26/2009

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I totally understand that miscarriage and infertility are very personal issues, so of course people handle them differently. And I thankfully haven't had to deal with it first-hand so I can only assume the emotional and physical toll that recurrent miscarriage and/or fertility treatment must take. But the thought of going through miscarriages numbering in the double digits is amazing to me. I honestly don't think I could do it.

And I'm all for women having the choice as to whether they start families young, or decided to wait and establish themselves first. What I can't understand though is how someone would be surprised when the baby doesn't fall into the grand plan with a click of the fingers. Again, I'm not suggesting that all older mothers fall into this category. But the ones in this story specifically stated they delayed motherhood because they wanted to enjoy their life first (with careers and travelling etc). Now if those are a woman's priorities - fine! Great! Women have choice now and that's fantastic! But surely if that has been your choice, you would also expect there to be a higher risk of problems in finally having that baby.

Sarah - posted on 10/26/2009

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I think it's great that research has been done into recurrent miscarriages and that they think they may be able to prevent it some cases. I truly hope that it helps women in the future!

The point about women intentionally waiting until their late 30's/40's before deciding to try and have children, i have to admit that i find it a bit strange. We all know that it's far more difficult to conceive and there is more likely to be problems when trying to have a child at a later age.
If a woman has made the conscious decision to follow her career or whatever instead of try for kids......then the urge to have kids couldn't have been that strong you know?
While i'm entirely sympathetic to those older women that decide they want kids after all, and then can't, part of me (and part of them i would imagine) would be a little like, 'well, i made my decision and now i face the consequences of it'

My husband and i made the decision to have our 2nd baby. Part of the reason for just 'going for it' was HIS age (he was 39) he didn't want to be an 'old man' while his kids were still relatively young etc etc......i think people DO need to take age into consideration you know?

It must be heartbreaking to go through a miscarriage, i don't think i could bear it once let alone 20 times!! To carry on trying tho is a very personal decision, and one i respect either way.

Sharon - posted on 10/25/2009

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I'm sorry you feel that way Sharon, but to me it just wasn't a big deal. I wanted more kids but nature does what she does. If I was destined to have only one child or needed to pursue adoption, then thats what would be.



I was speaking of myself and my own feelings about it. And I'm coming from a forum where a girl who couldn't handle the two kids she had made a big screaming deal out of every instance where her period was late = a pregnancy and she demanded attention and sympathy, preferably shown by flowers and a card. She annoyed the fk out of me. Two days late and WAH WAH WAH. Frankly I didn't really believe her. She had two kids she couldn't handle and she showed us pictures of mushrooms growing out of her toilet seat, DRAMA QUEEN. Supposedly the mushrooms were the fault of someone else.



Then there are sincere women who are trying really hard fail. Not through any fault of their own. I didn't mean to make you feel targeted, and that statement was probably overly broad. I dunno, I just didn't see the lack of a pregnancy as a failure, it was just something that wasn't. Does that make sense?



I'm probably affected differently because I was told I would never have kids of my own without major surgery and it happened anyway. shocker of shockers. I was so grateful to have my one child, every thing else was just a bonus. I refused to get excited about the pregnancy, I refused to let anyone buy a gift until I was 38 weeks pregnant. If I let myself get hopeful then bad luck would strike... weird I know but its how I coped.



It has to be different for someone who hasn't even had one pregnancy but I haven't been there.

Sharon - posted on 10/25/2009

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Ok first I want just shout from the rooftops about this discovery of natural killer cells. AWESOME!



Second... My kids are 4 yrs & 3 yrs apart. Not because we wanted it that way and not for lack of trying either. We had wanted our kids 2 yrs apart or less.



I figure I had a LOT of miscarriages as I was frequently late. But I was more accepting of what nature had to deal out. If it wasn't to be, it wasn't to be. I have to say I'm kind of disgusted by the women who cry and wail when their period is a few days late and they get a positive test and then they "miscarry". To me its not a miscarriage until you're more than 2 months along. Things went wrong and your body fixed it.



Waiting until you are 40 yrs old to have a baby - good & bad. If you are going to wait that long you kind of have to accept what nature deals out. If you're lucky enough for science to help you - GREAT! But if it can't then accept it and move on.



People have known since - well damn - they've always known that older women have a difficult time conceiving and carrying to term. Its lifes natural progression. I think its great science can help these women, now we have more options. 40 isn't that old, 60 well, lol you'd have to be NUTS.



Overall I'm glad science has found this out. But for those women who deliberately put off children - well I'm glad they established themselves first but who can be surprised when it doesn't work out at the later age?

Jocelyn - posted on 10/25/2009

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I think that the discovery of the Natural Killer Cells is a wonderful thing. There is no way that I would let myself go thru 5 miscarriages, let alone 20! I think my therapy bill would be extremely high if that were the case... I can see it now...get pregnant, go for your routine blood tests, they scan for the cells, a few days later you are on steroids, and in turn DO NOT miscarry. Or get the blood test before you even start trying!

Now, the women who choose to wait until later in life, imo they should expect something to go wrong (now I don't mean seriously wrong, just it should take more time to conceive, etc.) Age increases your risk of miscarriage, so why would they be sooo surprised when things don't go according to the textbook? They should be surprised when things go easily!

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