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Women risking 'unnecessary fertility test'

Women with fertility and recurrent miscarriage problems are being offered unproven and potentially risky tests and treatments, say researchers.

The study, published in the British Medical Journal, involved a team of doctors from several UK universities who say fertility clinics are increasingly offering tests to measure natural killer (NK) cells in the blood.

NK cells are in the womb and multiply during early pregnancy but their full function is unknown. The study says there is no scientific basis for offering the tests or treatments which include the administration of powerful drugs which may have serious side effects.

The tests are based on speculation that recurrent miscarriages and infertility problems are in some way linked to a malfunction of NK cells. Women are treated with steroids or immunosuppressant drugs to try to reduce the number of cells and their activity.

However, the team argues that the tests provide no useful information about what is happening in the uterus. Nobody is fully aware of the purpose of the NK cells which vary greatly in number in healthy individuals.

The researchers say, not only is there no evidence to justify the use of the tests, it is wrong to offer women powerful treatments which are known to carry risk, and which are not licensed for use in reproductive medicine.

Lead researcher Dr Ashley Moffett from the University of Cambridge said, "Women in this situation are quite understandably desperate and, because these cells appear to have unique qualities and are found in the uterus during early pregnancy, they have been latched on to as the one thing that something can be done about.

"But as we still don't know what their function is, it is totally premature to be thinking about any sort of intervention."

Dr Mark Hamilton, of the British Fertility Society, agreed with the conclusions of the paper. He said the validity of the tests was unproven, and that it was wrong to advise women to take on treatment of no proven benefit and potentially hazardous.

"The reproductive medicine community is acutely aware of how desperate couples either with a history of infertility or recurrent miscarriage are to have a baby. However as with all medical interventions, it is a fundamental principle of good medical practice that safety concerns are addressed.

"Great care has to be taken not to take advantage of couples merely because they are desperate and offer treatment which is sometimes expensive and often intrusive without adequate justification."

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