We started providing reproductive immunology testing in 1989 to treat recurrent miscarriages and help couples and individuals have the babies they wanted so very much. As pioneers in reproductive immunology, we have refined our testing and treatment in very specific and thorough protocols. To date, we have diagnosed and treated hundreds of families. This blog post provides an overview of how we work and a description of some of our tests that diagnose reproductive immunology issues. For a full discussion of our lab tests and reproductive immunology issues, see our webpage, Miscarriages Can Be Prevented.
Reproductive Immunology Consultation and Testing for Other Physicians
At RIA Lab, we can provide our reproductive immunology testing services in several ways. We can work with a patient’s existing Physicians or Reproductive Endocrinologists, providing thorough testing and consultation for their patients’ diagnosis and treatment. Physicians can access all necessary information on our website, including reproductive immunology testing order or requisition forms and information on both our miscarriage protocol and our IVF protocol. Some Reproductive Endocrinologists will only do their immunological testing with RIA, because of the high quality of our test results and service.
Reproductive Immunology Testing, Treatment and Monitoring Direct to Patients
We can also work directly with patients, providing consultations, testing, treatment and continuous monitoring through pregnancy and birth. We have found that sometimes patients come to us after an exhausting and frustrating journey of looking for a solution to their inability to have children and often being told again and again by various physicians that there is nothing they can do. Patients can start the process with RIA Labs by downloading our Patient Registration and Clinical Information forms and calling or emailing to set up a consultation by phone or office visit.
The two primary reasons other doctors and direct patients come to us for consultations and testing are after the patient experiences 1.) recurrent miscarriages or 2.) implantation failure with IVF (in vitro fertilization).
Reproductive Immunology Testing: Miscarriage Protocol
Our miscarriage protocol involves pre-pregnancy laboratory tests and treatments. At Reproductive Immunology Associates, we do antinuclear antibody (ANA) panels, antiphospholipid antibody (APA) panels, leukocyte antibody detection tests, and immunophenotype testing. We also recommend doing a DQA1 test on partners, and an NK cell with IVIg test for women.
Antinuclear antibodies (ANA) Panel
The antinuclear antibodies panel is tested in women who have a history of recurrent pregnancy loss and failed IVFs, and we suspect an autoimmune or connective tissue disease. Antinuclear antibodies cause destruction within a cell or cells and can result in tissue inflammation. The placentas in these women are inflamed and weakened. Some of our patients have placental villitis and vasculitis, which is associated with recurrent miscarriage and can recur in subsequent pregnancies.
Antiphospholipid Antibodies (APA) Panel
Women who have had recurrent miscarriages and/or failed IVF cycles should be tested for antiphospholipid antibodies (APA). Antiphospholipid antibodies can interfere with implantation and the formation of a healthy placenta. APAs can also damage the walls of blood vessels, allowing blood cells to stick and leading to blood clots in the veins or arteries.
With every miscarriage, there is a 10% chance the mother will develop an antiphospholipid antibody. Women who have autoimmune diseases sometimes have antiphospholipid antibodies before becoming pregnant.
Antipaternal Leukocyte Antibodies Panel
Women who have had recurrent pregnancy loss should have their antipaternal leukocyte antibodies measured. The production of antipaternal leukocyte antibodies in early pregnancy is normal and works to block the mother’s immune system from attacking paternal antigens on the developing fetus. A lack of these antibodies leads to first and second trimester miscarriages.
DQ Alpha Genotyping
The Human Lymphocyte Antigen (HLA) system is part of what determines a person’s immune system and that immune system recognizes as foreign. Studies have shown if a mother is HLA/DQ alpha-compatible with their fetus, she can develop more autoimmune processes like rheumatoid arthritis and antiphospholipid antibody syndrome in early pregnancy. In addition, in couples who want to have children but share a HLA DQ alpha determinant, the woman’s immune system natural killer (NK) cells can over-produce toxins called TH-1 cytokines. DQ Alpha Genotyping is a really important test for couples who have experienced recurring miscarriages or failed IVF. Read our previous blog post about DQ Alpha Genotyping here.
Natural Killer Cell with IVIg Assay
Natural killer cells exist to detect small cancer cells and kill them before they turn into tumors. If natural killer cells are highly active, they can misinterpret the fetus as a cancer and “kill” the fetus. This assay tests the killing power of NK cells and whether or not IVIg can inhibit NK cell activity during in-vitro fertilization.
Reproductive Immunology Testing: IVF Protocol
Our IVF protocol involves pre-IVF laboratory tests and treatments. At Reproductive Immunology Associates, we do the antiphospholipid antibody (APA) panel explained above, antithyroid antibody (ATA) panels, and immunophenotype (IP) testing, as well as natural killer cells with IVIg and DQ alpha genotyping, also described above.
Antithyroid Antibody (ATA) Panel
This test is done for women with recurrent IVF failures. It is sometimes done for women with recurrent miscarriages. Antithyroid antibodies are a strong indication of something called polyclonal B-cell activation, which is implicated in reproductive failure. When the immune system identifies a pathogen, such as bacteria, it generates antibodies that are created by B cells. Polyclonal B-cell activation is the production of many different antibodies by many different B cells.
Immunophenotype (IP) Test
The immunophenotype refers to the relative amounts of T-cells (helper and suppressor cells), B-cells (antibody producers) and NK-cells (natural killer cells) in the bloodstream. The immunophenotype measures NK- cells and Ctotoxic B-cells in women who have had multiple failed IVFs.
If you need reproductive immunology testing, contact the physicians at RIA Labs today. We provide cost-effective consultations and are known for our thorough testing protocols, developed over almost 30 years of experience.
Photo of natural killer cell by NIAID on Flickr. Some rights reserved.