Things you wondered about immunology & infertility
We can diagnose possible pathologies and take further actions
Sometimes despite having great quality embryos, no pathology in your uterus, normal endometrial receptivity, and even successful conceiving you might still experience recurrent miscarriages or implantation failures. It would seem there is no explanation. However, let us explain immunology and how you may be impacted.
We know when creating the embryo, your eggs are fertilized by your partner’s sperm. When the sperm enters your body, your immune system (which protects your body from infections caused by foreign cells) may treat the sperm harshly. Often killing it or anything it changes. It basically can cause your body to reject your embryo during the course of pregnancy.
If this sounds like your case, you might consider IM Map (also called Immunological Map) test. It is performed on an endometrial biopsy in the luteal phase and a blood sample is taken for following up with an immunotherapist. If there are any abnormalities detected, the right immune therapy suited to each patient can be offered.
If you are asking whether it is worth arranging this test, as a preventative measure to maximize your results, then our advice is the following:
If this is your first embryo transfer: No, wait
If you have experienced implantation failure or repeated miscarriages: Yes, but first it is best to rule out possible genetic failures by performing a karyotype test on both partners and/or an aneuploidy screening by NGS (PGT-a), initially PGS.
There are still a lot of people (including doctors) skeptical about this kind of testing. It is a very new area (when taking into account the influence of these two fields). Therefore, there haven’t been enough tests and experience yet to statically find what is true and not true. This is due to the variety of symptoms as well as the different effects the medications have on individuals. In order to be precise, it is necessary to have a large number of diagnosed cases of the same pathology, which are comparable and have been treated differently under study conditions. Subsequently, it is evaluated whether there are differences in the success achieved between the two groups, and the probability that this is simply due to chance. The greater the difference between the groups and the greater the number of homogeneous cases treated, the greater the probability of finding a difference, even if it is small.
What do you need to submit prior to an IM Map?
- Completed medical history about you, your partner, and your families
- All recent test results from the past year and a half (gynecological exams, all blood work, genetic testing, sperm analysis if applicable, etc.)
- A detailed summary of all cycles including:
- -number of mature eggs collected (own or donor eggs)
- -number of embryos on day 1, 3, and 5 (i.e. summary of embryo development for all cycles)
- -PGT-a results (if applicable)
- -specific cycle results (negative beta-hCG, biochemical pregnancy, miscarriage at week ‘X’)
After reviewing all mentioned information, the specialists will then indicate what additional (and if any) testing you should carry out. You may need to be prepared to travel to a country where the investigation is performed, as some tests might not be available in your own country (or are much more expensive).
How much does it cost? First of all, it depends on the country. In European countries, the investigation will be up to 220 USD. However, the exams crucial for receiving a doctor's opinion can be around 1500 USD in the Czech Republic. Which locations can we offer tests? Spain, Greece and we established a link with an immunology specialist here in Prague, Czech Republic. Let us know if you wished to receive more details. We are here for you as always ?.