All about Immune tests and IVF (Who Needs It)
My results of immune testing
Alan beer immune book
Immune System Relation With Reproductive System
I learned about the link between Immune System and IVF by reading Dr. Alan E. Beer's book (Is Your Body Baby Friendly). I later researched about it and gathered some valuable information.
When an embryo implants, our internal environment take it as a foreign body, in start it looks inflamed. With passage of time normal woman's body and her immune system accommodate with it and gets settled. During implantation time estrogen and progesterone are released by ovaries. Estrogen needs first followed by progesterone and then a combination of both needed to maintain a healthy pregnancy. If the body produces antibodies against estrogen and progesterone then pregnancy will fail.
The generally accepted reasons for reproductive failure are:
- Chromosomal Abnormalities
- Immune System Problems
- Abnormal Uterine or Cervical Anatomy
- Environmental factors
- Infections and Illness
According to Dr. Beer all these directly or indirectly related to immune system activity. Dr. Beer also anticipate that most commonly recognised problem for IVF failure and miscarriages will be immune problems. As much as 80% pregnancy lose and 40 % unexplained infertility is the result of auto-immune diseases.
Who Needs Immune testing:
There are three types of people who needs immune testing. The ones who have General Health problems others with reproductive problems and the last one with previous pregnancy problems.
General Health Problems:
- Thyroid Condition
- Insulin Resistance
- Lupus or Rheumatoid Arthritis
- Family history of stroke, heart problems, alopecia
- With history of Depression
- Chronicle Fatigue Syndrome
Reproductive System Problems/ Infertility:
- Secondary Infertility
- Pelvic Inflammation
- Two IVF failures or miscarriages after the age of 35
- Three IVF failure or miscarriages before the age of 35
- Poor egg production for stimulated IVF cycle
- Miscarriage of normal baby without any known cause
- Unexplained infertility
- One blighted ovum
Previous Pregnancy with Problems:
- Retarded fetal growth
- Cervical Incompetence
- Pre=term labour
- Unexplained uterine bleeding in first pregnancy
Here is a detail list of immune tests you or your husband will need. Blood tests are usually shipped to USA from all over the world, there they are tested to check the presence of antibodies. Some diagnostic tests from your Gynaecologist also necessary to determine the presence of autoimmune activity.
In Immune testing blood is drawn in test tubes which have different colour top to identify the type of test that will be performed. Then those test tubes shipped to USA special laboratories, where the results are available within a week usually although some tests can be performed locally. Standard blood tests are these.
HLA-DQ Alpha Testing:
Crime tests labs use this blood test to identify DNA or finger prints. It contains four main alleles numbered 1 to 4. The DQ-Alpha 1 and 4 have further sub-types (1.1)(1.2)(1.3) then (4.1)(4.2)(4.3). DQ Alpha test carried out on blood sample of both partners.
Each person has 2 DQ alphas, one from mother and one from father. If the person is healthy, it means upon arrival in uterus of his/her mother NK cells did not became active and hence the pregnancy survive. If NK cells becomes active and they kill early implantation then every other turn chance of NK cells becoming active increases. They interfere in early implantation and kill embryo. Hence the women remains infertile.
Leukocyte Antibody Detection(LAD):
LAD test also called Crossmatch test. It measures the level of blocking antibodies in woman 's blood. If this test measures inadequate antibodies, then it means woman body is not able to protect fetus. Hence it rejects pregnancy.
The Reproductive Immunophenotype:
This unique panel of tests is devised by Dr. Beer to analyse the concentration of white blood cells, if they are elevated it predicts future pregnancy loss. This panel of test is helpful for women who are unable to become pregnant or suffer miscarriages.
CD3(Pan T cells):
Woman with autoimmune diseases like rheumatoid arthritis, thyroid problems etc will have elevated levels of CD3 cells. People with healthy immune system will have normal range values and the one with weaker immune system will have lower range values.
Normally infertile women or the one with miscarriages will have elevated values of CD4 cells. They are very important white blood cells and drive many types of lymphocytes. In case if the woman have lower range of values then further other diagnosis are important as it could point out some serious illnesses such as AIDS and HIV.
In women with infertility or miscarriage these cells will be in low range. They help to maintain the function of Th-1 lymphocyte cells.
These are usually on higher end values in women with infertility or recurrent miscarriages. Sometimes values are even greater than 12which explain immune issues.
CD56+/CD16+ Natural Killer Cells:
In women with infertility values are on higher end. These cells produce TNF-alpha which kills the embryo and placenta hence becomes the cause of IVF failure.
CD56+ Natural Killer Cells:
These cells can be activated by a failed pregnancy. They become more aggressive as more pregnancies failed. Percentages of 18% or above predicts the poor reproductive outcome.
Progesterone and thyroid can be affected by the activity of these cells. Patients with excess of these cell do not respond well on medication like gonadotropin and follitism. These patients also can have joint problems, depression, headache and fever.
Natural killer cell Assay:
In this test women cell checked with cells who me they can kill. For example when killing ratio is 50:1 it means there are 50% more cells than the targeted cells. The aim should be to reduce the natural killer cells power to 15%.
Anti nuclear Antibody test (ANA):
If a women test is positive for ANA or borderline positive then it's a strong indication that women has some undiagnosed autoimmune disease. ANA test result consider positive when ratio is 1:40 or higher than that.
Anti DNA/histone antibodies :
This is another test which could be done and comes under immune testing. Unfortunately I don't understand it much.
Anti phospholipid antibodies / APA:
Most of the laboratories do cardiolipin and Lupus anti coagulant test and don't know much about other tests related to APA like serine, inositol and ethanol amine.
If APA positive then there is strong possibility of presence of other immune disorders and there is 50% likelihood of NK cells and also TH1:TH2 cytokines ratio.
Lupus anticoagulant antibodies :
This test most of the time comes as positive with Lupus patients but those who doesn't have Lupus can also produce a positive results. This test should be repeated in 6 to 8 weeks time to make sure that positive result was not due to some temporary infection in body. These tests measure the time in which blood become a clot.
Antisperm antibodies :
This test should be carried if sperms are not moving much or dead. There are many tests to check these antibodies but the most reliable is immunobed binding Antisperm Antibody Assay.
Methylene tetra hydro foliate reductase (MTHFR):
If a woman has defective MTHFR then it means she is unable to process folate properly. This is an important test and it is checked with a test name PCR. With this polymerase chain reaction DNA is analysed and this test is commonly used in forensic science.
TH1:TH2 Cytokines Assay:
This test counts the each type of cells and result is given with tnf Alpha and interferon Gemma. My tests result picture is given to show you how the result looks like.
Please make sure I am not a doctor neither a specialist. I am only a curios women with a bit of knowledge which I wanted to pass you on. Make sure you consult your doctor before using any of this data. Good luck.