The unit’s team consists of highly qualified experts in clinical and laboratory immunology, who provide consultations and tests for the diagnosis and management of immune therapy in patients with fertility issues, pregnant women with autoimmune diseases, and congenital and acquired immunodeficiencies.
The immune system and autoimmune and alloimmune disorders
The immune system is one of the most intricate and complex systems in the human body, whose task is to be the first line of defence against various antigens. Antigens are cell-surface proteins that identify the cell as ‘own’ or ‘foreign’. The immune system neutralises foreign proteins through immune response and, in this way, maintains homeostasis (the tendency of the organism to maintain stable internal conditions, resisting change in the environment).
Immunological problems related to repeated pregnancy loss and recurrent implantation failure are caused by disturbances in the antibody response, which fall into two major categories: autoimmune and alloimmune. An autoimmune response is the mother’s immune response to the pregnancy. In the case of autoimmune disorders, the woman’s immune system targets her own proteins or, in other words, treats them like an emerging disease, and autoantibodies are antibodies that attack her body’s own antigens. In alloimmune disorders, the mother’s immune response targets those genetic components of the pregnancy that the father contributed; that is, it attacks the male partner’s proteins. Blood tests can determine both types of immunological problems.
Immunological problems are part of the environmental factors for sustaining a pregnancy. The chance for a successful pregnancy largely depends on the intricate interplay of complex immunological dispositions, aiming at transforming the uterus into a supportive environment for sustaining embryo development, the growing foetus, and the placenta. Sometimes though, these immune mechanisms can turn wrong. Depending on when and how it happens, the woman may lose the pregnancy or have difficulty conceiving spontaneously or following an IVF.
Immunological testing in couples with fertility issues is assigned depending on the data from their medical history and at the discretion of the clinical immunologist. The treatment applied is complex and tailored to address individual cases’ specific issues and test findings. The personalised approach is applied in every individual case.
The most frequent immunological abnormalities in patients with fertility issues are cell factors in the first place, especially the subpopulations of NK cells in peripheral blood and endometrium, whose balance plays a key part in regulating the maternal immune response to the embryo, implantation and sustaining a healthy pregnancy. A significant percentage of patients with autoimmune disorders which is the presence of various autoantibodies.
Immunological tests are assigned after a consultation with a clinical immunologist in all pregnant women with a history of recurrent miscarriage or high-risk pregnancy, i.e. complications like preeclampsia or HELLP syndrome in a previous pregnancy, and in pregnant women with known autoimmune disease or immunodeficiency.
For immunological testing of peripheral blood, a venous blood draw is performed. No preliminary patient preparation is necessary, and there is no need to observe a specific day of the menstrual cycle or to be fasting.
For immunological testing of the endometrial parameters, a biopsy is done by the treating gynaecologist during the implantation window period of the menstrual cycle.
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Lab test results
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