Female- Reproductive Immunophenotype Test
Repeated Implantation failure (RIF) and recurrent pregnancy loss (RPL) are among the most challenging scenarios in reproductive treatment in women. Reproductive immunology refers to the phenomenon of immunological arrest that allows a mother to accept a foreign embryo. The active and innate immune systems are accepted components of this process and many studies link various immunological abnormalities with recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL) (Ghafourian et al., 2014; Thum et al., 2004).
Natural Killer (NK) cells are one type of immune cell – normally circulating in blood. These express CD56 and as their name suggest have the ability to directly kill foreign or abnormal cells. Elevated levels or functionality can be harmful to the reproductive process and block successful implantation, even when the embryo is capable. They produce cytokines and specifically TNFα.
CD 19+/5+ (B-1 Cells)
B cells may be of two subtypes known as B-1 and B-2 cells. When we examine a second surface-displayed marker on CD19 expressing cells known as CD5, the cells are classified at B-1 B cells. They represent a class of B cells that is involved in autoimmune disorders (conditions where the body mounts an immune response against a body tissue). Women with elevations of these cells may be at risk for thyroiditis and the premature menopause. One should pay close attention to the numbers of these cells when attempting to identify patients with immune-related conditions.
The most common causes of recurrent pregnancy losses is immunologic risk factors within the uterus or the environment in which the pregnancy grows. Immunologic causes of occult pregnancy losses are different from early and late pregnancy losses. Once an accurate diagnosis is made and appropriate immunotherapy administered, a live birth rate of 70 to 80 percent can be expected.
Female sample collection
Blood : The blood sample should be transported in EDTA vacutainer tube
Endometrial Biopsy : Endometrial Biopsy may be transported in Saline or RPMI Media
Factors indicate for the need for immune testing:
Ghafourian M, Karami N, Khodadadi A, Nikbakht R. Increase of CD69, CD161 and CD94 on NK cells in women with recurrent spontaneous abortion and in vitro fertilization failure. Iran J Immunol. 2014;11(2):84–96
Thum MY, Bhaskaran S, Abdalla HI, Ford B, Sumar N, Shehata H, Bansal AS. An increase in the absolute count of CD56dimCD16+CD69+ NK cells in the peripheral blood is associated with a poorer IVF treatment and pregnancy outcome. Hum Reprod. 2004;19(10):2395–400
Natural Killer (NK) cells are one type of immune cell – normally circulating in blood. These express CD56 and as their name suggest have the ability to directly kill foreign or abnormal cells. Elevated levels or functionality can be harmful to the reproductive process and block successful implantation, even when the embryo is capable. They produce cytokines and specifically TNFα.
CD 19+/5+ (B-1 Cells)
B cells may be of two subtypes known as B-1 and B-2 cells. When we examine a second surface-displayed marker on CD19 expressing cells known as CD5, the cells are classified at B-1 B cells. They represent a class of B cells that is involved in autoimmune disorders (conditions where the body mounts an immune response against a body tissue). Women with elevations of these cells may be at risk for thyroiditis and the premature menopause. One should pay close attention to the numbers of these cells when attempting to identify patients with immune-related conditions.
The most common causes of recurrent pregnancy losses is immunologic risk factors within the uterus or the environment in which the pregnancy grows. Immunologic causes of occult pregnancy losses are different from early and late pregnancy losses. Once an accurate diagnosis is made and appropriate immunotherapy administered, a live birth rate of 70 to 80 percent can be expected.
Female sample collection
Blood : The blood sample should be transported in EDTA vacutainer tube
Endometrial Biopsy : Endometrial Biopsy may be transported in Saline or RPMI Media
Factors indicate for the need for immune testing:
- Two or more miscarriages after the age of 35 OR 3 miscarriages before the age of 35
- Two IVF failures after the age of 35 OR 1 failed IVF before the age of 35
- Poor egg production from a stimulated cycle (6 eggs or less)
- Pre-existing immune problems (Lupus, Rheumatoid Arthritis, MS)
- One healthy pregnancy with all subsequent pregnancies ending in miscarriage
- Endometriosis, especially stage 1 & 2
- Cold and flu-like symptoms, sore throat noted regularly after ovulation, IUI, or IVF transfer
- Family history of immune disorders, either side of the family
Ghafourian M, Karami N, Khodadadi A, Nikbakht R. Increase of CD69, CD161 and CD94 on NK cells in women with recurrent spontaneous abortion and in vitro fertilization failure. Iran J Immunol. 2014;11(2):84–96
Thum MY, Bhaskaran S, Abdalla HI, Ford B, Sumar N, Shehata H, Bansal AS. An increase in the absolute count of CD56dimCD16+CD69+ NK cells in the peripheral blood is associated with a poorer IVF treatment and pregnancy outcome. Hum Reprod. 2004;19(10):2395–400