Reproductive Immunology Testing

Testing of the immune system is often undertaken in the following cases;

  • Recurrent miscarriage (usually classed as 3 instances)
  • Repeated failure of IVF (usually classed as 3 failed embryo transfers)
  • Unexplained difficulties trying to achieve a pregnancy
  • History of immune disorders
  • History of thyroid disease
  • Previous pregnancies where there have been placenta related complications such as pre-eclampsia, premature delivery or fetal growth restriction

The following tests can be carried out in routine clinical practice:

Reproductive Immunophenotype (RIP)

This test measures the percentage of white blood cells, also known as lymphocytes in the blood stream. These are major cells in the immune system. Increased levels may indicate increased immune response against an implanting embryo.

Antinuclear Antibodies (ANA)

This test checks for issues such as lupus, rheumatoid arthritis and other immunological diseases. These antibodies cause inflammation in the uterus during implantation. Women with high levels of these antibodies are less likely to become pregnant or carry a pregnancy to term.

Antiphospholipid Antibodies (APA)

These are proteins that can be found within the blood stream that may increase the risk of getting a blood clot or experiencing pregnancy losses.

Anti-DNA

High levels of this test are associated with lupus and other autoimmune rheumatic and inflammatory disorders that can result in pregnancy losses and affect fertility.

A positive result in the above tests indicate that the woman’s body may see embryos as foreign organisms and mistakenly mount an immune response in an attempt to get rid of the embryo(s), leading to implantation failure or miscarriage.

Thrombophilia

During a normal pregnancy, the ability of the mother to produce blood clots within the placenta and womb is suppressed. Some mother’s however may have acquired or inherited conditions that mean the clotting of the blood nourishing the baby is not suppressed and this can cause problems as it can contribute to pregnancy losses.

Tests for inherited thrombophilia: Factor II & V, MTHFR gene mutation

These are genetic conditions, some of which are very common. All thrombophilia (‘sticky blood conditions’) can cause problems for maintaining an adequate blood supply to the uterine lining and to the growing placenta leading to increased rates of implantation failure and miscarriage.

Natural Killer Cells Assay

Natural killer cells are one of three types of lymphocytes. They have an important job as they help fight infections and cancer cells. For some women who experience recurrent miscarriage these cells are found to be too active.

Th1:Th2 Cytokine Assay

One of the other types of lymphocytes are called ‘T cells’ and there are two types. Th1 cells orchestrate the immune system’s response to attack cells that are infected or abnormal. Th2 cells oppose the response of Th1 cells. It is important that a natural balance of Th1 to Th2 cells is achieved. Those with high ratios can experience issues but treatment is available.

Elevated CD57 cells within the endometrium

Sometimes it is necessary to take a sample (biopsy) from the lining of the womb (endometrium) and test for the presence of two different types of lymphocytes; CD57+ cells and T regulatory cells. High levels of these cells can contribute to pregnancy loss and infertility.

Anti-thyroglobulin antibody

These antibodies can be found in women with infertility and recurrent miscarriages. One possible effect is the release of toxins when an embryo tries to attach to the uterus resulting in miscarriage.

Anti-Ovarian Antibodies (AOA)

High AOA levels are seen in cases with unexplained infertility. It is higher in cases of PCOS, premature ovarian failure (POF) and endometriosis. In women with elevated levels of AOA, there is diminished response to ovarian stimulation.

Anti-sperm antibody (male partner)

This test looks for antibodies in semen that can damage or kill the sperms resulting in reduced motility, interfering with fertilisation of the eggs (oocytes). Higher levels of anti-sperm antibodies make it harder for the sperm to fertilise an egg.

Anti-sperm antibody (female partner)

This test looks for antibodies in the blood stream that can damage or kill sperm resulting in reduced motility or interfering with fertilisation. A woman can have an “allergic reaction” to her partner’s semen and make sperm antibodies which may affect fertility.

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For more information about Reproductive Immunology Testing or to book an appointment, simply call us on 01483 917 507