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Hum. Reprod. Advance Access published online on March 10, 2005

Human Reproduction, doi:10.1093/humrep/deh804
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Human Reproduction © European Society of Human Reproduction and Embryology 2005; all rights reserved
Received October 25, 2004
Revised January 16, 2005
Accepted January 20, 2005

Article

New debate: natural killer cells and reproductive failure--theory, practice and prejudice

Raj Rai 1*, Gavin Sacks 2, and Geoffrey Trew 3

1 Department of Obstetrics and Gynaecology, Faculty of Medicine, Imperial College London, St Mary's Hospital, London, UK
2 Department of Obstetrics and Gynaecology, Faculty of Medicine, Imperial College London, St Mary's Hospital, London, UK; Department of Reproductive Medicine, Hammersmith Hospital, London, UK
3 Department of Reproductive Medicine, Hammersmith Hospital, London, UK

* To whom correspondence should be addressed.
Raj Rai, E-mail: r.rai{at}imperial.ac.uk


   Abstract

The relationship between peripheral blood natural killer (NK) cells and reproductive failure is one of the most controversial areas in reproductive medicine. Amidst much publicity, peripheral blood NK cell testing is being promoted as a useful diagnostic test to guide the initiation of a variety of immunosuppressive therapies amongst patients with either recurrent miscarriage or infertility. We contend (i) that at present there is no scientific basis for the introduction of NK cell testing into routine clinical practice, and (ii) that the use of immunosuppressant agents based on the results of such testing may potentially be harmful.

Keywords: NK cells; peripheral blood; pregnancy; TNF-{alpha}.
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