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20 October 2023

Immunology Testing

Miscarriages, or loss of pregnancy during the first 23 weeks, along with implantation failures are heart-breaking events that no one wants to go through.

There is much debate about the role of the immune system in promoting or preventing a healthy pregnancy. Research has shown that an “overactive” immune system may negatively affect pregnancy outcomes.

At Harley Street Fertility Clinic, we offer a comprehensive suite of tests to check various aspects of your immune system and related clotting factors, pertinent to fertility.

Some of these tests are performed at our specialist partner laboratory: the Clinical Immunology Laboratory at Rosalind Franklin University. The immune tests we perform are:

 

Natural Killer (NK) cell assay

This test is a  measure of the killing power of the  NK  cells in your blood. NK  cells are present in everyone and their purpose is to fight infection. It is believed that elevated levels of NK cells are associated with failed embryo implantation and miscarriage. Additionally, we measure how much reduction in NK killing power is observed in the laboratory after adding a solution of medication (Intralipids) to a sample of NK cells from your blood. The second part of the test measures the numbers of various types of white cells in your blood as a percentage of the whole. We look at these specific types of cells because elevated concentrations of these cells have been shown to be associated with various fertility problems. For example:•CD56+ Natural Killer cells•CD19+5+ B cells are associated with auto-immune antibody production.

 

TH1:TH2 Cytokine ratio

Cytokines are chemical messengers in the blood. High levels of the TH1 pro-inflammatory cytokine, TNF-alpha, in particular, have been shown to be associated with reduced egg quality, implantation failure and miscarriage.This test measures the ratio of TNF-alpha in your blood compared to the anti-inflammatory cytokine, IL10. We also measure the ratio of Interferon-gamma compared to IL10.

 

Inherited thrombophilia and autoimmune factors (Thrombotic Risk profile with auto-antibodies)

Thrombophilia  (‘sticky blood conditions’) can cause problems in maintaining an adequate blood supply to the uterine lining and to the growing placenta leading to increased rates  of implantation failure and miscarriage. Undiagnosed autoimmune disease may also be associated with an increased risk of pregnancy failure, potentially due  to  elevated  TNF-alpha ratios. Our screening panel  includes tests  for Factor  II prothrombin gene mutation,  Factor  V  Leiden gene mutation,  MTHFR  gene mutation, antinuclear Antibodies, Mitochondrial antibodies,  Anticardiolipin antibodies,  Smooth muscle  antibodies, and Ovarian antibodies.

Prof Kenneth Beaman, Director and Founder of Clinical Immunology Laboratory at Rosalind Franklin University, said about the tests performed in the Immunology Lab at Rosalind Franklin Institute:

“The NK cells need to be active during pregnancy, so we want them to be active but not killing. We use the blood samples to see if there are bad or cytotoxic NK cells. The samples are sent to the lab in special containers with the samples, that will keep them fresh until they reach the lab. If the blood samples are sent late, the lab is not able to find any useful information. The samples are received between 12 to 16 hours after they are shipped and are analysed the same day. The data is sent back on the same day they are analysed. The shipping time/analysis is similar in Europe and USA. ”

 

Professor Beaman took part in our webinar about miscarriages and implantation failure. To watch the webinar, please click below.