Immunological Disorder Leading to Infertility [Complex Case]

Thyroid Abnormality

Xiao Yu, a 37-year-old woman, sought assistance from Dr Maw-Sheng Lee at Lee Women’s Hospital after trying to conceive for a long time without success. Xiao Yu mentioned that she had undergone surgery to remove her thyroid due to thyroid abnormalities. Currently, she relies on thyroid hormone treatment to maintain normal thyroid hormone level.

AMH below 1

Due to her advanced maternal age, Dr. Lee arranged for Xiao Yu to undergo hormone blood tests. It was found that Xiao Yu’s AMH level was only 0.5. However, Dr. Lee said, “Don't be afraid! Although the ovarian reserve is low, it is still possible to collect an adequate number of eggs through multiple retrieval cycles.” Fortunately, after three retrieval cycles, a total of 10 eggs were collected. With ongoing medication adjustments, the third retrieval even yielded 6 eggs, which is considered a good outcome for low AMH level. Xiao Yu’s husband had good sperm quality, and after fertilization, they obtained a total of 6 embryos.

Immune system problem:
insufficient natural killer cells

Before embryo transfer, further examinations were conducted, revealing Xiao Yu had an immune system problem with insufficient natural killer cells (NK cells). Low NK cells could affect embryo implantation. Dr. Lee arranged Intravenous Immunoglobulin (IVIG) for her. “Regarding how to treat infertility associated with immunological deficiencies, Lee Women’s Hospital has published a related research paper in a scientific journal, and our study has shown that such treatment contributes to successful pregnancies!” added Dr. Lee.

After successfully conceiving following the first embryo transfer, Xiao Yu gave birth to a baby at Lee Women’s Hospital, under the care of Dr. Maw-Sheng Lee. The child is now 4 years old. This March, Xiao Yu returned to discuss a second pregnancy with Dr. Lee. With two remaining embryos, the transfer is scheduled. Last week, the pregnancy test was positive.

Dr. Lee also wants to encourage everyone, “Many patients become discouraged when they discover a low AMH level during tests. Although it may be low, it is still possible to collect embryos. Don’t loss hope! Don’t be afraid! If you have problems, come to us, and together we will find solutions.”

Ho Y-K, Chen H-H, Huang C-C, Lee C-I, Lin P-Y, Lee M-S and Lee T-H (2020) Peripheral CD56+CD16+ NK Cell Populations in the Early Follicular Phase Are Associated With Successful Clinical Outcomes of Intravenous Immunoglobulin Treatment in Women With Repeated Implantation Failure. Front. Endocrinol. 10:937. doi: 10.3389/fendo.2019.00937