The role of immunological disorders in the diagnosis of infertility is not often discussed. This is a mistake, because even 6 to 12% of cases of infertility may be due to a malfunction of the immune (immune) system of one of the partners.
The role of immunological disorders in the diagnosis of infertility is not often discussed. This is a mistake, because even 6 to 12% of cases of infertility may be due to a malfunction of the immune (immune) system of one of the partners.
Are you wondering what tests you need to do to diagnose the immune cause of infertility? We are discussing them in the article below. First of all, we will explain what immunological infertility really is.
When the immune system is harming instead of supporting
The immune system is to protect our body against the penetration of pathogenic microorganisms, including viruses and bacteria. Sometimes, however, it does not fulfill its function and instead of defending, it begins to attack us. For a couple trying for a child, such a situation may hinder or even prevent conceiving a child. We say then that the patient is struggling with the so-called immune infertility. In its course, a woman’s or man’s immune system produces antibodies that attack cells that are involved in the fertilization process.
Anti-sperm antibodies test
Anti-Sperm Antibodies present in the female immune system attach to the sperm, preventing them from moving – they inhibit the so-called progressive movement. ASA antibodies disturb the egg-sperm interaction, which means that these cells cannot properly connect. In addition, they may not allow the embryo to implant in the uterus. The production of ASA antibodies occurs primarily in the endometrium and cervical canal, but we can also find them in the male body. Then they attack sperm and other components of male sperm. They are destroyed before they even reach the egg.
Anti-nuclear antibodies test
ANA (anti-nuclear antibodies) have an adverse effect on the uterine mucosa and cause continuous inflammation. ANA may cause oocytes and embryos to be of inferior quality &ndash because of that the embryo may not implant properly in the uterus. There are 3 ANA test panels: ANA1, ANA2 and ANA3. The ANA1 test is always performed first. It determines if antinuclear antibodies are present in the blood at all. If the result is positive, the other two are performed.
Anti-ovarian antibodies test
The presence of AOA (anti-ovarian antibodies) is closely related to endometriosis and polycystic ovary syndrome. The presence of these antibodies in a woman’s body can cause anovulatory cycles, and in the worst case, infertility. This is because AOA antibodies fight the corpus luteum and the oocyte transparent sheath. As a result, there are disorders in the production of sex hormones.
Anti-cardiolipine antibodies test
Testing for anti-cardiolipin antibodies in the IgG and IgM class is recommended in the case of an unexplained thrombotic event, thrombocytopenia, eclampsia and habitual miscarriages.
Beta2 glikoprotein-Itest (IgM, IgG)
Beta2 glycoprotein-I is another antiphospholipid antibody. It is formed in the liver and attacks phospholipids of cell membranes of cells involved in the implantation of the embryo in the uterus. Elevated levels of this antibody increase the risk of thrombotic complications and may make it difficult for a woman to remain pregnant.
Lupus anticoagulant test
The lupus anticoagulant is a group of antiphospholipid antibodies. Its presence is associated with an increased risk of thrombosis and habitual miscarriages.
Anti-TPO antibodies test
Antibodies against TPO are proteins directed against one of the enzymes involved in the synthesis of thyroid hormones – thyreoperoxidase. The purpose of the test is to determine the level of these antibodies. Too low may indicate RA (rheumatoid arthritis), too high – for Graves’ disease or Hashimoto’s disease.
Anti-TG antibodies test
Thyroglobulin antibodies attack thyroid cells. Their presence can make it difficult for the embryo to nest in the uterus and lead to miscarriage. Elevated levels of thyroglobulin antibodies are found, among others, in with such diseases as Hashimoto’s disease, Graves-Basedow disease or thyroid cancer.
Assessment of blocking antibodies (allo MLR)
Antibodies that block the embryo from attack by the mother’s immune system. Reduced levels of blocking antibodies or lack of them can cause pregnancy loss. This will happen because the pregnant immune system will treat the embryo as a foreign body and will want to get rid of it.
Apal Polymorphism test in gene IGF2
The presence of Apal polymorphism in the IGF2 gene in a man increases the risk of habitual miscarriages. Therefore, when a woman loses pregnancy again, it is recommended that her ground floor perform a genetic test for this polymorphism.
KIR and HLA-C
KIR and HLA-C genotyping are genetic studies recommended for couples whose fertility problems may have an immunological basis. Both tests are most often performed for habitual miscarriages and problems with embryo implantation. KIR (Killer-cell immunoglobulin-like receptors) are receptors located among others on the surface of cytotoxic cells (NK – Natural Killer). NK cells are part of our immune system. They identify and destroy cells that they consider foreign or abnormal.
NK cells cytotoxity assay
NK cells make up 80% of all placental lymphocytes. Thanks to them it is possible to properly implant the embryo and its growth in the following weeks of pregnancy. There should not be too many of them in a woman’s body. Why? Because it can promote miscarriages and reduce the effectiveness of the in vitro procedure.
Immunophenotype test
Immunophenotype testing is helpful in diagnosing the causes of miscarriage. An immunophenotype is a set of antigens (molecules) specific to a given group of white blood cells, i.e. lymphocytes. First of all, immunophenotype testing will determine whether individual lymphocyte groups are in the right proportions. In this way, you can find out if the person’s immune system is functioning properly.
Allergy testing for semen
Some women have an allergic reaction after several hours after contact with semen. It is manifested by itching, redness and swelling of intimate places – the vagina, vulva. Other typical allergy symptoms may also occur, including coughing, shortness of breath, rash, nausea and vomiting. In extreme cases, anaphylactic shock may occur which will already pose a direct threat to life. When it occurs, immediate medical intervention is needed. All these symptoms are a reaction to the prostate antigen (PSA) present in the male semen (exactly in the semen plasma).
Why to do immunological testing?
Immunological testing are a whole set of various types of specialized tests. By undergoing immunological diagnostics, the couple have not only the chance to find out the real cause of the difficulty in conceiving a child, but also to get professional help that will bring her closer to fulfilling her dreams of having children.
How immunological infertility treatment looks like?
Diagnosing the cause of problems with conceiving a child is really the first step to the desired parenthood. Patients with immune infertility receive treatment that is intended to suppress the body’s excessive immune response or stimulate the immune system.
