During pregnancy, a unique type of immunity develops to support the growth and development of the fetus. Normally, the genetic disparity between the mother and the fetus could trigger the mother's immune system to reject the fetus. However, in a healthy pregnancy, the mother's immune system adapts to accept the fetus through active immunological tolerance. Active immunological tolerance involves the mother's immune system successfully identifying the embryo and adapting to prevent its rejection. Additionally, it actively facilitates essential processes for implantation and maintaining the pregnancy. However, when there is a deregulation or imbalance in the mother's immune system, it can compromise the successful implantation and development of the embryo.
This deregulation can lead to implantation failure, recurrent miscarriages, and other pregnancy complications. It is important to understand and address any immune system dysregulation to optimize the chances of a successful pregnancy outcome.
What the Reproductive Immunology Full panel offers:
This panel offers the most comprehensive Reproductive Immunology testing which allows detection of both idiopathic reasons (Autoimmunity Dysfunction) or risk factors due to “incompatibility between embryo genetics and your immune system (Alloimmunity Dysfunction) associated with reproductive immunopathology, such as recurrent spontaneous abortions, idiopathic infertility, and implantation failures in both natural and assisted reproduction attempts.
The first part of a complete reproductive immunology examination (Autoimmunity Dysfunction) involves 3 main tests, namely the NK cell profile (incl. Regulatory T-Cell (Tregs) analysis), the NK cell cytotoxicity assay and the Th1/Th2 cytokine ratio assay. We call this type of testing “Reproductive Autoimmunity Dysfunction Testing” which a patient can test through individual tests or all together in a panel.
The second part of this panel, includes a genetic analysis of possible “immunological incompatibilities” between the two partners that may affect fertility, including HLA DQα-1 partner matching and KIR-HLA-C mismatch testing among others.
NK cell profile/ NK cell cytotoxicity
NK cells (Natural Killer cells) are a type of immune cell that play a role in the body's defense against infections and cancer. However, in the context of fertility and pregnancy, elevated levels of NK cells in the peripheral blood and, as a consequence, potentially in the uterus, can sometimes lead to fertility issues and recurrent miscarriages. When NK cells are overactive or dysregulated, they may mistakenly recognize the developing embryo as a foreign object and attack it.
Th1/Th2 cytokine ratio
The Th1/Th2 ratio is a concept that relates to the balance between two types of immune cells: Th1 (T-helper 1) cells and Th2 (T-helper 2) cells. These cells play different roles in the immune system and are involved in regulating immune responses. It is believed that an imbalance in the Th1/Th2 ratio, with increased Th1 activity and decreased Th2 activity, may create an environment that is less supportive of successful implantation and pregnancy maintenance which may lead to increased inflammation and immune responses that could potentially harm the developing embryo or interfere with implantation.
HLA DQα-1 partner matching
In a healthy pregnancy, the mother's immune system adapts to accept the fetus through active immunological tolerance. This process involves the identification of at least a minimum level of genetic diversity from the father, including diverse human leukocyte antigen (HLA) genes. Studies suggest that fetuses with HLA haplotypes similar to the mother's are more likely to be aborted. Through this test we can predict possible embryo HLA combination and compare to the mother for compatibility.
To maintain tolerance, Immune suppressive regulatory T cells (Tregs) and uterine natural killer cells (uNKs) need to regulate the local uterine immunity and prevent rejection of the embryo. The activation of uNKs is facilitated by killer immunoglobulin-like receptors (KIRs), which interact with fetal HLAs. The balance between activating and inhibitory KIRs determines the activation or inhibition of NK cells, crucial for successful pregnancy outcomes. Defective placentation, pre-eclampsia, fetal growth restriction, and recurrent spontaneous abortion are associated with higher frequencies of inhibitory KIRs in women. Specific combinations of maternal KIR and paternal HLA-C genes may indicate a higher risk of infertility. This test allows genotyping of maternal KIR genes and comparison with possible fetal HLA genotypes to predict a possible mismatch.
SAMPLE COLLECTION: For collection of blood samples, you should arrange for a healthcare professional to draw the bloods for you according to the instructions, in a licensed medical facility.
SAMPLE STORAGE & SHIPPING: Samples should be stored and shipped at ambient temperature and away from light. Delivery of samples should be planned between Monday and Thursday but not Friday or during the Weekend. Sample collection and pick-up by courier should take place on the same day.
RESULT TURNAROUND TIME: Depending on how busy the lab is, we estimate you will get your results in 20 business days from the day your sample reaches us *.
FERTILYSIS Reproductive Full
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* Please be advised that the turnaround time for specialized diagnostic tests is indicative and not guaranteed and may be extended due to a variety of factors, including but not limited to need for additional clinical evaluation of results, repeat of analysis in cases of unclear or ambiguous results and need for resampling in case of inadequate specimen quality. Therefore, the results will be available in the indicated timeframe as long as there are no additional overheads, as stated above, that may extend turnaround time.