Immunological Testing

The immune system plays an important role in implantation, placental development, and the normal progression of pregnancy, but it is not involved in every reproductive difficulty. At Adella Fertility, we recommend immunological testing only when there are specific medical indications.

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Immunological Problems

When Is an Immunological Assessment Needed?

Immunological tests are not a mandatory part of the initial assessment for every couple experiencing difficulties conceiving. They are discussed in cases of recurrent pregnancy loss, a known autoimmune condition, characteristic symptoms, or laboratory findings that suggest an immune-related disorder.

Recurrent Pregnancy Loss

After two or more pregnancy losses, testing for antiphospholipid antibodies may be recommended. The aim is to determine whether there is evidence of antiphospholipid syndrome, which may increase the risk of blood clotting in the placenta and affect the development of pregnancy.

Evidence of Autoimmune Disease

Further assessment may be required in patients with diagnosed lupus, rheumatological disease, autoimmune thyroiditis, or symptoms such as joint pain, rashes, unexplained fever, and pronounced dry eyes or mouth. In these cases, we work with the patient’s overall clinical picture rather than interpreting a single laboratory result in isolation.

Each Test Has a Specific Diagnostic Purpose

Which Immunological Tests May Be Recommended?

Lupus anticoagulant is part of the basic assessment for antiphospholipid syndrome. A positive result does not necessarily mean that lupus is present and should be interpreted in the context of reproductive history, other test results, and diagnostic criteria.
IgG and IgM antibodies are assessed. Persistently elevated values may be associated with antiphospholipid syndrome, but a single positive or borderline result is not sufficient to establish a diagnosis.
IgG and IgM antibodies support the assessment for antiphospholipid syndrome. They may be recommended in cases of recurrent pregnancy loss, previous thrombosis, or other findings that increase suspicion of an immune-related disorder.
ANA may be tested when a systemic autoimmune condition is suspected. A positive result can also occur in completely healthy individuals, so it does not by itself establish the cause of infertility and is not an indication for treatment on its own.
Thyroid peroxidase antibodies, anti-TPO, and, when appropriate, thyroglobulin antibodies, anti-Tg, support the assessment for autoimmune thyroid disease. The results are considered together with TSH, FT4, symptoms, and endocrinological evaluation.
Testing of IgG, IgA, IgM, C3, and C4 may be recommended when there is evidence of a systemic autoimmune condition, immune deficiency, or recurrent infections. These parameters are not routinely included in infertility assessment and are used only when clinically necessary.
Antisperm antibodies may bind to sperm cells and affect their motility or interaction with the egg. Testing is not routinely recommended as part of the initial infertility assessment and is considered only in selected cases.

From Medical History to a Well-Founded Decision

How Is Immunological Testing Performed?

Accuracy in Immunological Testing

Why Is a Result Not Always Definitive?

Immunological markers may change over time and can be affected by infections, inflammatory processes, medications, and pregnancy. This is why a single positive or borderline result rarely provides a complete answer.

When necessary, testing is repeated and interpreted according to the specific diagnostic criteria. Our aim is to determine whether the finding has genuine clinical significance.

A Positive Antibody Result Does Not Always Mean Disease

How Are the Results Interpreted?

Low antibody levels can also be found in completely healthy individuals and do not necessarily indicate a clinical condition. The significance of the result depends on the type and level of the antibody, repeat testing, symptoms, reproductive history, and the remaining findings.

Our role is to distinguish a clinically relevant abnormality from an incidental laboratory finding.

Questions

Frequently Asked Questions

It may be recommended in cases of recurrent pregnancy loss, previous thrombosis, a known autoimmune disease, or symptoms and findings that suggest a disorder of the immune system.
No. Immunological testing is not a mandatory part of the preparation for every IVF procedure. We recommend it only when the medical history indicates that the results may provide useful information.
It is an autoimmune condition associated with certain antibodies and an increased risk of thrombosis or pregnancy complications. Diagnosis requires a combination of laboratory and clinical criteria.
Certain antibodies may rise temporarily after an infection or inflammatory process. Repeat testing helps determine whether the abnormality is persistent and has true diagnostic significance.
Not necessarily. ANA may also be positive in people without symptoms. The result is interpreted according to the titre, ANA pattern, clinical symptoms, and the other investigations.
It is not routinely recommended. There is currently insufficient evidence to support reliably using NK cell count or activity to determine the cause of infertility or to predict treatment outcome.
The test identifies variants in KIR genes associated with receptors on certain immune cells. Its role in implantation is still being studied, so the result should not be used independently to establish a diagnosis or prescribe treatment.
No. The first step is to determine whether the abnormality is persistent, clinically significant, and associated with a specific condition. Treatment is discussed only when there is a well-supported diagnosis and a clear individual assessment.

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Maria & Christian

Thank you to the entire team at Adella Clinic for their professionalism and incredible personal care. I first visited the clinic during my journey to becoming pregnant, continued to have my pregnancy monitored there, and gave birth under the care of Dr Makedonova.

Throughout the entire experience, I received exceptional attention, care and support. Every visit was a pleasure – from the smiles and assistance at reception to the dedication and professionalism of the whole medical team. I always felt calm, understood and in safe hands.

Thank you from the bottom of my heart! I highly recommend Adella Clinic to anyone looking for a high standard of medical care combined with a warm and personal approach.

Maria Velinovska