A couple visited our center (woman aged 37 and husband 43 visited our center at 2013 while they had 2 RSAs the last two years, and they had a child 5 years old. Tests for thrombophilia were performed ((Leiden_G1691A),  (MTHFR, C677T), (MTHFR, A1298C), plasminogen-β (-455 G>A),(HPA-1), (PAI-1 4G/5G), Apoliprotein Ε (Ε2/Ε3/Ε4). All those tests showed heterozygous and the lady was suggested to take know anti-platelet therapy.

In the next three months there was positive pregnancy, but RSA was occurred for the third time and therefore a new meeting was set with the couple to test for NK cells (total and endometrial, NK activity, and ETA (embryotoxicity).

ALL NK markers were not normal, but ETA was OK.  So, the major cause of the problem of RSAs was NK cells. Soya oil emulsion dose targeted for the lady was infused intravenously and anti-platelet therapy was administered orally. Later at October 2016 had a pregnancy positive test and this time avoided RSA, and she had another dosage of soya oil emulsion until the 3 month of gestation to avoid the RSA because of NK cells. At the 17th week, amniocentesis was performed and karyotype was normal and since then pregnancy went under normal conditions.

Conclusion: International literature has shown in many cases the women that have RSAs may be because of thrombophilia or the biggest reason the NK levels, or endometrial NK, or the NK activity. For these reasons, it is necessary to test for thrombophilia all NK markers in order to have regulated the immune response of the woman before and during the pregnancy.