We have 30 different
types of white blood cells as part of our immune system. In a reproductive
immunophenoptype panel, eight of the most important ones are tested.
Disorders in any of these eight are prognosticators for a
future pregnancy loss regardless of how the conception was achieved.
Listed below are an explanation of some of these cells,
representative tests and their significance.
- CD-3
cells. Normal range: 63 - 86%
These are the most important cells
in the immune system. They are low when the immune system is poorly functioning
(suppressed) and normal when the immune function is normal. Infertile patients
and those with repeated pregnancy loss have values in the high normal range.
These individuals have immune systems that are very strong or overactive. An
overactive immune function is frequently associated with a 5% incidence of
autoimmune disease including but not limited to thyroiditis, lupus, and rheumatoid
arthritis.
- CD-4
(T – helper cells). Normal range:
31 – 53%
These cells direct the action of other lymphocytes. In women with infertility or miscarriage these cells are high because they
are helping CD3 cells.
- CD – 8
(T – cytotoxic suppressors). Normal range: 17-35%
These cells coordinate how
strongly or how weakly the immune system reacts. They are like referees. In women with repeated miscarriage or
infertility, these cells are frequently low as they become exhausted
negotiating the hyperactive CD – 3 cells and CD – 4 helper cells.
- CD -19
(B cells). Normal range: 3-8%
These cells are plasma cells
(white blood cells called B cells that have been triggered to make antibodies).
IgM is the first antibody produced to fight anything that enters our body that
shouldn’t. This antibody stays in the
blood and then, as the immune response progresses it produces IgG (gamma
globulin G) and resides in the lymph system.
IgA, (gamma globulin A), is the last antibody made in an immune
response. It resides in and protects the organs, skin and GI tract. When this
antibody appears, it means that the immune response is completed and cannot go
any further.
When IgA responses (organ
immunity) are present in any test for reproductive failure it usually means
that the patient has an autoimmune process such as lupus, rheumatoid arthritis
or other disorders.
CD- 19 B cells are almost always
high-normal or very elevated in women with an immune cause for their
infertility or recurrent pregnancy loss.
There is frequently a greater than 12% elevation. This is a very
important indicator that the immune system is being over-worked. Endometriosis
also provokes CD -19 activity.
Immune and/or blood clotting pathologies are responsible for
approximately 30% of repeated pregnancy loss.
Antiphospholipid antibodies
Antiphospholipid antibodies (APA)
have been linked to poor reproductive performance including infertility and
repeated pregnancy loss. The typical treatment for this disorder is heparin or
lovenox and baby aspirin.
Aspirin prevents intravascular
thrombosis (blood clotting) from occurring in the early utero-placental
vasculature. There are many herbs including but not limited to *dan shen, chuan
xiong, tao ren, yi mu cao, hong hua and wang bu liu xing which do the same thing
that aspirin does in the APA+ patient. The difference however, is that the
herbs in combination with acupuncture do not cause stomach problems or bleeding
problems or ulcers. Additionally, herbs are given in formulas which usually
address both the cause and the manifestation of a pathology whereas aspirin treats
only the manifestation.
I am not suggesting that you do
not take aspirin if it is recommended by your reproductive endocrinologist;
only that you consider getting treated with acupuncture and herbs
simultaneously as this type of therapy is synergistic, complementary, and potentiating
of the Western regimen.
Acupuncture and herbal medicine
have been used for immunoregulation and blood clotting causes of infertility
and/or repeated pregnancy loss for millennia.
My clinical experience has shown
that when combining acupuncture and herbs with the appropriate
immunosuppressants such as dexamethasone or IVIG the effect is more pronounced then
when using one of these therapies alone.
We have seen, for example, many patients who underwent immunosuppressive
and/or anticoagulant therapy whereupon pregnancy was not achieved or, pregnancy
was attained only to end in miscarriage. Subsequent cycles which included
acupuncture and herbs resulted in increased numbers of take-home baby’s.
Obviously this is not the case with each and every cycle but we have seen
success enough times with the inclusion
of acupuncture and herbs where success was not previously manifest that
experientially we can conclude that the inclusion of acupuncture and herbs
significantly improves the desired outcome.
A combined approach is recommended
because Western immunosuppressive therapies though efficacious, treat the
manifestation of the problem and not the underlying cause which means that your
chances of conceiving this time will
improve but once you stop taking the medicine, the effects will cease. Acupuncture
and herbs strive to reach deeply into ones system and strongly alter the
causation or etiology of infertility and repeated pregnancy loss; for good.
Acupuncture and herbs function to enhance and regulate the immune function
and, offers a longer term solution. Drug therapies such as dexamethasone,
prednisone and IVIG (intravenous immunoglobulin therapy) are much stronger than
acupuncture and herbs and therefore, have a more immediate effect. But acupuncture
and herbs have a gentle, constant and longer term effect. Therefore, combining
both therapeutic models will serve to 1) alleviate the immediate cause of
infertility and/or repeated pregnancy loss and 2) strengthen and regulate the
immune system to make you stronger and help balance and normalize your immune
function so that you can increase your future fertility potential.
Natural Killer Cell Activity
(cytotoxicity)
NK cells are lymphocytes that are present in endometrium and in the decidua during pregnancy.
NK cells are lymphocytes that are present in endometrium and in the decidua during pregnancy.
Women with recurrent pregnancy
loss, endometriosis and primary autoimmune conditions (such as rheumatoid
arthritis and systemic lupus erythematosis), have been found to demonstrate elevated levels of NK cells, resulting
in failed implantation.
Immunoglobulin (IVIG) has an ability to down-regulate and deactivate NKa cells. Though IVIG has been shown to be effective, its effect is manifest only during the treatment and for a short period of time thereafter. Including acupuncture and herbs in the treatment protocol not only enhances the effect of immunomodulation but, by regulating the immune response, has been shown to have longer lasting effect. While it is true that we have not conducted formal studies on the effect of acupuncture and herbs in the suppression of NK activation, we can report success based on clinical experience.
Immunoglobulin (IVIG) has an ability to down-regulate and deactivate NKa cells. Though IVIG has been shown to be effective, its effect is manifest only during the treatment and for a short period of time thereafter. Including acupuncture and herbs in the treatment protocol not only enhances the effect of immunomodulation but, by regulating the immune response, has been shown to have longer lasting effect. While it is true that we have not conducted formal studies on the effect of acupuncture and herbs in the suppression of NK activation, we can report success based on clinical experience.
Certain acupuncture points such as
Stomach 36, Spleen 6, Ren17, and Ren 6, along with certain herbs including but
not limited to *huang qi, shan yao, bai zhu, shu di, dang gui and lu rong have
been used to successfully complement IVIG therapy via their immunoregulatory
activity.
We
have been treating fertility challenges in New York City since 1996. We have
offices in Manhattan, Westchester and Long Island.
Our
staff consists of specialists in acupuncture, herbal medicine, nutrition, yoga,
Maya abdominal massage, mind-body-meditation, hypnotherapy and clinical
counseling.
We treat patients from many reproductive medicine clinics including:
NY Weill
Cornell
Saint
Barnabas
Long
Island IVF
Center
for Reproductive Medicine and Infertility (CRMI)
Connecticut
Fertility Associates
Kofinas
Fertility Institute
Cooper
Center for IVF
RMA
NYU
Sher Institute for Reproductive
Medicine
And others…
Please feel free to call with your
questions or enjoy a free 15 minute mini-consultation with any of our
practitioners.
By the way, we are the only clinic
that offers a Full Refund program.
Ask about it when you call!
212-685-0985
*These herbs and acupuncture
points are listed for illustrative purposes and I strongly recommend that you
do not self medicate. Take herbs only when prescribed by a Board certified
herbalist and one who specializes in treating infertility.