FertilityZone

Hi - I thought some of you may find this information useful, my results of these tests showed my levels at 21% but if I used IVIG would take them down to 8% within normal levels.

CD56+ CD16+ Natural Killer Cells normal levels 3-12%

Natural Killer cells of this type are produced in the bone marrow and these cells produce a chemotherapy molecule called TNF (Tumor Necrosis Factor). This molecule is involved in eliminating cancer cells that may develop in normal individuals. Tumor Necrosis Factor also causes joint damage in women with rheumatoid arthritis. These Natural Killer cells are often elevated in women with infertility and recurrent miscarriage. The Tumor Necrosis Factor produced by these cells kills the rapidly dividing cells of the embryo and placenta often resulting in IVF or GIFT failure, blighted ovum or a chemical pregnancy where the BhCG elevates slightly and then quickly returns to non-pregnant levels. Normal levels for this cell population are 3-12%. The CD 56 and the CD16 molecules on the surface of these cells are special glue (adhesion) molecules that allow the Natural Killer Cells to attach to cancer, placental and embryonic cells. Once glued to the placental cell, it sprays Tumor Necrosis Factor on the cell and kills it.

CD 56+ Natural Killer Cells normal level 3-12%

These Natural Killer (NK) Cells include CD56+/16+ Natural Killer Cells and CD56+ Natural Killer cells with lack of a CD16 molecule. Natural Killer Cells are activated by a pregnancy that fails or a fertilized embryo that degenerates. CD56+/16+ Natural Killer Cells are produced in the decidua and they are even more geared up to kill than those from the bone marrow. They produce large quantities of Tumor Necrosis Factor locally that kills the placental cells and the fetal cells. The normal range of CD56+ Natural Killer cells is 3-12%. Levels of 18% or greater correlate with poor reproductive outcome.

Edited to say that depending on your levels treatments are usually steroids or IVIG.

Quoted from Alan Beer

Immune Pathology Evaluation of the Endometrium

Introduction
Immune pathology studies of a biopsy of the endometrium (uterine lining) in women with recurrent pregnancy losses, IVF failures and implantation failures show that lymphocytes can damage the lining as well as the embryo. These lymphocytes are not seen in the uterus of fertile women. To find if a woman has this problem an endometrial biopsy is done by a gynaecologist on cycle day 26 or a few days before menstruation.
These unwanted immigrant cells that take up house-keeping in the uterus are:

1.Activated macrophages that secrete IL-1 (toxic to the lining and to the embryos);

2.CD 57+ cells that secrete tumor necrosis factor alpha (toxic to the embryos and uterine tissue). These cells can cause stromal hemorrhages, subchorionic hemorrhages and early premenstrual spotting;

3.Mast cells (associated with hives and rashes in the skin of allergic individuals), when present in the uterus, cause stabbing pains, bad premenstrual syndrome, severe cramping and ill feelings after intrauterine insemination or embryo transfer.

Most individuals with category 5 immune problems have increased numbers of CD 57+ cells in the blood, and increased cytotoxicity (killing power) of these cells when tested in the NK assay. Some women, who have had category 5 immune problems for a long time, have natural killer cells that have migrated to the uterus and are living there as "tissue residents."

Background

At the time of ovulation the uterus and the endometrial lining are prepared for implantation. The glands and the endometrium are thickened to 10-14 mm, have formed three zones, blood vessels and blood flow have entered zone three and the glands are producing rich sugar-like secretions to nourish the embryo until it implants. New molecules are forming on the lining to make it receptive and sticky (integrins) for the embryo. Heparin molecules are arriving into the uterus to help cross link the embryo with the lining. Lymphocytes are arriving (TH-2) that will secrete cytokines (growth molecules) that help with implantation and growth of the embryo. All of this can be seen by immune pathology and can be seen as in good order. Immune pathology can also find the TH-1 natural killer cells that do not put the uterus and the lining in good order.

Many of the women that I see have a chaotic situation in the uterus. The lining development is disordered because of CD57+ cells that have taken up residence there. CD57+ cells live in the uterine glands, lining and in the stroma (soon to become decidua). This stroma is the tissue that nourishes the glands and the lining. It will soon nourish the placenta and we call this tissue decidua. When the embryo arrives, these CD57+ cells are activated and secrete Tumor Necrosis Factor alpha, which causes a breakdown in the lining of the uterus, the glands and the stroma. When the stroma breaks down, hemorrhages and blood cysts appear. This can cause severe cramping and some bleeding. This results in the uterus becoming a hostile environment for the embryo. Pregnancies fail very early or do not occur at all.

Women at Risk for Elevated CD57+ cells in Uterine Tissue

Women who are at risk for having elevated CD57+ cells in the uterine tissue are:
1.Women with a known autoimmune disorder such as fibromyalgia, lupus, rheumatoid arthritis, Crohn's Disease, thyroiditis, chronic fatigue syndrome, Raynaud's disease, mixed connective tissue disorder and ulcerative colitis;

2.Women with a history of dysplasia of the cervix, carcinoma in situ of the cervix or papilloma virus infections (HPV);

3.Infertile women with endometriosis prior to their first assisted reproductive technology (ART) or IVF cycle;

4.Women with recurrent spontaneous abortions who lose their pregnancies earlier and earlier or who have secondary infertility;

5.Women with two IVF failures;

6.Women with repeated implantation failures;

7.Women who experience flu like symptoms with implantation, transfer or implantation failure;

8.Women who experience stabbing pelvic pains or intense cramping with inseminations or embryo transfers.

In many women, all of these situations and complaints are discounted and minimized by most reproductive endocrinology or OB/GYN doctors. These symptoms are not in your head as figments of your imagination. They are real and demand attention and workup.

What can Diagnose this Problem?

1.An endometrial biopsy done two or three days before expected menses or, at the latest, on the first day of menstruation of a normal non-conception cycle.

2.An endometrial biopsy done 10-14 days post transfer when the pregnancy test is negative and before menstruation begins.