Immune Testing
To establish any issues that may be preventing a successful IVF treatment, we carry out a comprehensive series of tests which check different aspects of your immune system. At The Fertility & Gynaecology Academy we feel it is important that you understand the different tests carried out.
Once we have identified the problem using the series of tests below, we can provide relevant immune therapy – for example Intralipids or IVIg infusions, Corticosteroids, Clexane, Progesterones and Lymphocyte Immune Therapy (LIT).
The HFEA’s view on immune testing is available here.
Natural Killer (NK) Cell Cytoxicity Assay And Immunophenotype
This test first measures the killing power of the NK cells in your blood. Secondly, it looks at the numbers of different types of white cells in your blood. We look at these specific types of cells because elevated concentrations of them have been shown to be associated with various fertility problems. For example:
TH1:TH2 Cytokine Ratio
Cytokines are chemical messengers in the blood. High levels of the TH1 pro-inflammatory cytokine – TNF-alpha, in particular – have been shown to be associated with reduced egg quality, implantation failure and miscarriage.
Leukocyte Antibody Detection (LAD)
This test requires a sample of blood from both the prospective mother (or gestational carrier) and another person (usually the prospective father). It measures the levels of blocking antibodies in the prospective mother’s blood to samples of white cells from the prospective father. Low levels of blocking antibodies are associated with higher rates of miscarriage and implantation failure.
HLA-DQ Alpha Testing
The test determines which DQ Alpha markers your body cells carry. To achieve the best results, this test is usually carried out for both the prospective mother and the prospective father. This is because where the prospective mother and father carry very similar markers, there is an increased chance that their embryos may carry identical markers to the mother. In that case, there may be an increased rate of implantation failure and/or miscarriage. This can be due to an increased immune response which may become more aggressive with each successive attempted implantation of a DQ Alpha matching embryo.
Testing By Uterine Biopsy
This test requires a small sample taken from the lining of the uterus, ideally before your period is due. The sample can be taken at our clinic or, in some cases, taken elsewhere and forwarded to us. Samples are analysed for excessive levels of uterine NK cells, for adequate levels of FoxP3 +ve T-regulatory cells and for the health and development of the uterine lining.
Tests For Inherited Thrombophilia: Factor II & V and 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, which results in increased rates of implantation failure and miscarriage.
Tests For Acquired Thrombophilia/Antiphospholipid Antibodies
Additional tests for thrombophilia may be available to you via your GP, but if not, can be arranged through The Fertility & Gynaecology Academy.
Screening For Autoimmune Factors
Add-on Treatments: Patient Information Leaflet
Please download our Add-on Treatments Patient Information Leaflet below for evidence and associated risks.
Undiagnosed autoimmune disease may be associated with increased risk of pregnancy failure, potentially due to elevated TNF-alpha ratios. A screening panel will commonly include tests for Antinuclear Antibodies (ANA), Anti-Histone and ds-DNA antibodies. These tests may be available to you via your GP, but if not, can be arranged through The Fertility & Gynaecology Academy.
Killer-Cell Immunoglobulin-like Receptors (KIRs)
KIRs are a family of protein receptors on the surface of NK cells, mostly inhibitory but some activating. There is an increased risk of implantation failure and/or miscarriage if particular members of the activating KIRs are missing. The risk can be reduced by using G-CSF (Neupogen).
Please also see our Reproductive Immunology section for further information and call for a consultation on 020 7224 1880.
Add-on Treatments: Patient Information Leaflet
Please download our Add-on Treatments Patient Information Leaflet below for evidence and associated risks.
