There is not enough evidence yet to link abnormal levels of uterine natural killer cells to infertility, British experts said yesterday.
There is no evidence to offer routine testing for these cells – and testing women with recurrent miscarriage or IVF treatment failures is still experimental, according to the scientific impact paper from the Royal College of Obstetricians and Gynaecologists.
The paper comes as an investigation into fertility clinics found many offering add-on treatments that were not backed by evidence.
Treatments such as glucocorticoids and intravenous immunoglobulin have been tested – but IVIg could have "serious adverse effects," the experts say.
And the evidence for gluticosteroids remains inconclusive.
A second paper sets out the merits of using endometrial scratching after recurrent miscarriage or IVF failure.
Its impact has not yet been evaluated, the experts warn.
Professor Adam Balen, who chairs the British Fertility Society, said: “These two papers look at the current available evidence which exists and give much-needed guidance to both healthcare professionals and the public on these two topics.
“It is important that patients receive full information about treatments, the current evidence for benefit and whether there are any side effects or risks associated with it.”
And Mostafa Metwally, vice-chair of college’s scientific committee, said: “We still do not understand the mechanism by which endometrial trauma may lead to improvements in IVF outcomes in women and further studies are needed looking specifically at its success among women undergoing their first IVF cycle.”
The Role of Natural Killer Cells in Human Fertility (Scientific Impact Paper No. 53). Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates (Scientific Impact Paper No. 54) RCOG. [abstract]
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