Immunology

Female examinations

Immunology laboratory of the clinic GENNET recommends various examinations to women with respect to their specific issues.

What examinations are recommended to women with sterility?

Women with sterility are unable to conceive spontaneously. We therefore look for the cause of problems at the very beginning of the process, i.e. in the stage of contact of sperm and egg, and we complete the investigation with examinations of general immunology diseases as well as tests of cellular immunity.

  • Basic parameters - serum immunoglobulin level, basic blood cell count, possibly complete blood count and CRP - examination focusing on basic anti-inflammatory markers.
  • Reproductive antibodies - anti-sperm antibodies, anti-ovarian antibodies, anti-zone pellucida (egg coat) antibodies - examination also focuses on response to reproductive antigens.   
  • Anti-phospholipid markers - set of examinations of coagulation factors, which can entail formation of microclots and thus lead to rejection of embryo, or to miscarriage.
  • Autoantibodies – antibodies against nuclear antigens (ANA) are a general marker of autoimmune diseases. Anti–TPO emerges in impairment of the thyroid gland and anti-Tg emerges in celiac disease. 
  • AMH (Anti-Mullerian hormone) – amount of this hormone is in correlation with individual ovarian reserve of eggs.
  • Activity of NK cells – blood of the patient is cultivated together with stimulation agents - sperm, trophoblast lines and unspecified strong activator, then the expression of CD69 on the surface of NK and NKT cells is observed. High expression of activation features after stimulation with sperm cells or trophoblast suggests an increased cytotoxic reactivity directed against antigens of the partner / fetus and it may affect the success of conception or increase the risk of miscarriage. Also, the numbers of NK and NKT cells in blood must not be too high.
  • Production of cytokines – blood of the patient is cultivated together with stimulation agents - sperm, trophoblast lines and unspecified strong activator - and the number of cytokines inside cells is observed. Production of embryoprotective IL-4 and IL-10 is required and a high amount of embryotoxic IFN-gamma and TNF-alpha is a sign of pro-inflammatory tendency of the body and a risk regarding pregnancy.

What examinations are recommended to women with infertility?

Infertile women become pregnant but are unable to carry the child to full term or give birth to a viable fetus. It is necessary to investigate in this group of patients whether tolerance to the fetus was induced or whether there is a risk of artery blockage with microthrombi. Women who were pregnant in the past, but pre-eclampsia or HELLP syndrome occurred in them, are investigated in a similar manner as well.

  • Basic parameters – serum immunoglobulin level, basic blood cell count or possibly complete blood count, CRP - examination focused on basic inflammatory markers. 
  • Number of T regulatory cells - cells that induce tolerance to the fetus. 
  • Anti-phospholipid markers – set of investigations of antibodies against coagulation factors which can entail formation of microclots and thus lead to rejection of embryo or to miscarriage due to insufficient fetal nutrition.
  • Autoantibodies – antibodies against nuclear antigens (ANA) are a general marker of autoimmune diseases, ENA antibodies present a risk regarding fetal development, anti–TPO emerges in impairment of the thyroid gland and anti-Tg emerges in celiac disease. 
  • AMH (Anti-Mullerian hormone) – amount of this hormone is in correlation with individual ovarian reserve of eggs.
  • Activity of NK cells – blood of the patient is cultivated together with stimulation agents - sperm, trophoblast lines and unspecified strong activator, then the expression of CD69 on the surface of NK and NKT cells is observed. High expression of activation features after stimulation with sperm cells or trophoblast suggests an increased cytotoxic reactivity directed against antigens of the partner / fetus and it may affect the success of conception or increase the risk of miscarriage.
  • Production of cytokines – blood of the patient is cultivated together with stimulation agents - sperm, trophoblast lines and unspecified strong activator - and the number of cytokines inside cells is observed. Production of embryoprotective IL-4 and IL-10 is required and a high amount of embryotoxic IFN-gamma and TNF-alpha is a sign of pro-inflammatory tendency of the body.

What examinations are recommended for women with recurrent failures of IVF cycles?

Panel for infertility is usually a good choice for these patients. It is necessary to consider the type of IVF treatment which was used for them in the past and whether embryos failed to develop or there was a problem only during the implantation of embryos in the uterus.

It is essential that the partner of the patient also undergoes the examination to have a comprehensive overview of the problem. We focus on semen analysis in his case.