Does having higher than ideal NK cell activity means I need immuno treatment?

barnowl

1 Posts

Reply Posted on: Feb 14, 2016 at 10:07pm

Hi Dr. Braverman, I recently took a RPL panel that revealed higher than ideal NK cell activity and I was told to use IVIg prior to the FET I had 2 weeks ago. I did intralipids instead which had some good effects but didn’t bring the CD56CD16 cell activity down to a “good” level. The FET failed, no implantation (grade AA and chromosomally normal embryo). Do you think I need immuno treatment? My background and test results:

- 3 early miscarriages from natural pregnancies. Only one miscarriage tested: trisomy 13

- Husband has 30-40% sperm DNA fragmentation. I'm 38 y/o now

- 2 IVF cycles (egg retrieval + ICSI + PGS) resulted in 4 euploid embryos, all frozen

- 1 controlled FET cycle: no implantation

Comprehensive RPL panel – issues found:

Higher than ideal NK cell activity

TSH higher than ideal at 3.45 (taking Levoxyl)

Tested positive for MTHFR, compound heterozygous (took low dose Lovenox during FET cycle)

Tested positive for PAI 1, one copy of 4G found (took low dose Lovenox)

Immuno Test Results:

NK ASSAY Complete (done last year before Intralipids)

50:1 - 22.6%

25:1 – 12.7%

12:5:1 – 8.3%

IGG12.5 50:1 – 18.6%

%CD3 – 65.8

%CD19 – 3.8%

%CD56CD16 – 29.8

%CD19CD5 – 5.2%

%CD6+CD56+(NKT) – 1.9%

TH1:TH2 Cytokine ratios:

TNF-a:IL-10(CD3+CD4+) Result:20.1

IFN-g:IL-10 CD3+CD4+) Result: 11.0

Treg (CD4/CD25/Foxp3+) Result: 0.6

NK ASSAY Complete (done this year
after Intralipids)

50:1 - 8.6%

25:1 – 5.4%

12:5:1 – 4.1%

%CD3 – 67.7%

%CD19 – 6.0%

%CD56CD16 – 24.2%

%CD19CD5 – 9.7%

%CD6+CD56+(NKT) – 2.0%

TH1:TH2 Cytokine ratios:

TNF-a:IL-10(CD3+CD4+) Result: 18.3

IFN-g:IL-10 CD3+CD4+) Result: 6.4

Treg (CD4/CD25/Foxp3+) Result: 0.7


ANA IFA, Ovarian, Hashimoto, Histone, DNA, SJogren antibodies, etc. all negative

All auto-antiphospholipid antibodies were negative

Thrombophilia panel, all negative except minor issues: MTHFR and PAI1

Dr. Braverman

2026 Posts

RE: Does having higher than ideal NK cell activity means I need immuno treatment? Posted on: Feb 15, 2016 at 7:58am

Your testing is vastly incomplete and now way to determine the therapy that you need . NK cell is really very small contribution to the ovarall innune picture . I suggest you fill out a consult form and schedule a free consult with me so we can discuss your case in detail.

Braverman Medical Team
Braverman Reproductive Immunology P.C.