In AAFC, we recommend immunology evaluation to some couples that have been facing unexplained infertility, implantation failure and repeated miscarriages, while all other parameters of their fertility have been normal.
What an immunology evaluation tell us?
An immunology evaluation is achieved through assessment of the immune system during a couple’s pre-conception period or early pregnancy with a series of comprehensive blood testing or specialized semen analysis.
The role of the immune system during reproduction has been a much-debated subject among specialist doctors and embryologists. Here at AAFC, we like to be thorough and explore all possibilities when assessing cases of unexplained infertility, implantation failure and repeated miscarriages. Therefore, we evaluate your immune system,when all other reasons for IVF failure have been ruled out.
In cases of adverse reproductive immunity, it is believed that your body develops antibodies that may be rejecting your partner’s sperms by treating them as invaders, or foreign entities, within your system. These are known as anti-sperm antibodies and their action can be easily overcome by the use of IVF with Intra-Cytoplasmic Sperm Injection (ICSI).
In other adverse immunity situations, you may have developed auto-antibodies (antibody against self, as it happen in auto-immune diseases, for instance) that may attack your early embryo as a foreign body.
In men with a small number of sperms in their semen (oligospermia), there may be a similar auto-immune condition, where they develop auto-antibodies against their own sperm cells (anti-sperm auto-antibodies).
These attacks on sperm or early embryo can be due to excessive action from your immune system’s natural killer cells, which, under normal circumstances, help the body to fight an infection. As a part of an immunology evaluation, we may assess the levels of natural killer cells in your blood, and if these are higher than normal, then one of the above adverse immunity scenarios may be taking place.
In these cases, we offer a pharmacological course aimed in lowering or suppressing the activity and levels of natural killer cells. Depending on your immunological assessment, your health and fertility history, we will prescribe you with a suitable treatment for this purpose.
Who may need an immunology evaluation?
This evaluation is recommended to couples with long unexplained infertility, recurrent miscarriages after a natural or assisted conception, and when all other known contributing factors have been ruled out.
Anti-sperm antibody evaluation is also recommended to men that have few sperms in their semen (oligospermia), especially if they have undergone a vasectomy reversal. In vasectomy, sperms continue to be produced, but they become trapped in the testes. The body, in order to clear the accumulating sperms, resorts in developing anti-sperm auto-antibodies for their destruction. When the vasectomy is reversed, these auto-antibodies continue to attack the freshly-produced sperms in the testes, resulting in oligospermia.
How is an immunology evaluation done?
For an immunology evaluation test you will need to attend our clinic in AAFC for providing a blood or semen sample, depending on the test.
A full analysis of the immune components of your blood or semen will be performed in our collaborator’s laboratory, The Doctors Laboratory (TDL) in the UK, which is widely recognized for being experts in reproductive immunology evaluation.
After we receive your immunology evaluation report from TDL, we will arrange a follow-up consultation, where we will discuss with you your results, potential options and treatments.
What can an immunology evaluation tell us about the success of an assisted reproductive technique?
To date there is no conclusive evidence about the role of anti-sperm antibodies / auto-antibodies, maternal auto-antibodies or natural killer cells during reproduction. Additionally, there is a real mix of reported outcomes after treatment for adverse reproductive immunity, which is not helped by the extensive variation of individual circumstances and other possible underlying causes of infertility.
If you are found to have increased levels of natural killer cells in your blood, and have experienced unexplained infertility and / or repeated miscarriages, then receiving treatment for this condition can offer you an extra chance of achieving your desired outcome.
We understand that undergoing a situation like this can be very stressful and emotional. Here at AAFC, we are prepared to offer you as much help and support as you may need, while continue looking and researching for the best and latest techniques and technologies that can help you and your spouse to have a family.