Finally after 6 months of waiting and saving... I had my immune panels DONE!!! I was supposed to do them yesterday, but couldn't go so I went today. So here is a description of the 2 panels (last panels) since the Dr told me today that after this NO MORE TESTING. So I'm here hoping we get an answer from this.1) Embryotoxicity Assay (EPA)IntroductionRecurrent pregnancy loss, unexplained infertility, and infertility associated with endometriosis affect a large number of reproductive age couples. Data are accumulating to suggest that a proportion of these individuals have circulating embryotoxins associated with their reproductive failure. It has been proposed that positive and negative embryotoxic factors provide the basis for a new classification of idiopathic recurrent pregnancy loss and in vitro fertilization (IVF) failure. The prevalence of embryotoxic activity among women experiencing recurrent pregnancy loss is 10% to 15% and among IVF failures is 20% to 25%. Embryotoxic factors have also been reported in women experiencing unexplained infertility and infertility associated with endometriosis.
Indications for TestingAll women experiencing unexplained infertility, implantation failure after IVF, infertility associated with endometriosis or two or more consecutive pregnancy losses should be tested for circulating embryotoxins.
Detection MethodEmbryotoxins are identiied by screening the patient's serum using a mouse blastocyst bioassay controlling for variability among mice. Two cell embryos are collected from superovulated mated CB6F1/J mice and cultured in media supplemented with FBS or 10% serum at 37° C with 5% CO2 and high humidity. Each sample is assayed in triplicate using three mice, with at least five embryos from the same mouse per well. Embryonic development is evaluated at 72 hours and the frequency of atretic embryos is recorded. Intra-sample (inter-assay) variation yields a coefficient of variation of 10%. When repeated samples from a given individual are evaluated, the coefficient of variation is 9.7%. Inter-operator variability is 4% inter-assay and 2% intra-assay.
Interpretation of Test ResultsA normal value is absent circulating embryotoxins.
Atretric Embryos %
Embryotoxins Absent < 9.4
Borderline 9.4 - 12
Embryotoxins Present > 12
Using the above thresholds, this assay has a specificity of 97%, positive predictive value of 83% and a negative predictive value of 74%, with p=0.0078.
2) Reproductive Immunophenotype (RIP)IntroductionIdentification of the type of relative concentrations of various white blood cell populations in blood is valuable in determining risk factors for pregnancy loss. Evaluation of circulating percentage of CD56+ cells has been shown to be associated with reproductive failure. An elevated ratio of CD4+/CD8+ cells is seen in a number of autoimmune disorders including reproductive autoimmune failure syndrome. Detection of elevation of circulating CD56+ cell is helpful in identifying individuals at risk for not implanting embryos and for losing a karyotypically normal pregnancy. Both of these patient populations can enhance live birth rates by treatment with intravenous immunoglobulin.
Indications for TestingAll women who have unexplained infertility or who fail to conceive after in vitro Fertilization and embryo transfer of apparently normal embryos or who experience two or more consecutive pregnancy losses should be tested for the presence of elevated percentage of circulating CD56+ cells. Elevated percentage of circulating CD56+ cells should be monitored during pregnancy to aid in management of treatment.
Detection MethodThe percentage of mononuclear cells expressing CD3, CD4, CD8, CD19, CD16 and CD56 is detected by flow cytometry using an immunofluoroescence technique.
Interpretation of Test ResultsNormal values in blood:
Lymphocytes %
CD3 51 - 79
CD4 30 - 52
CD8 16 - 40
CD19 5 - 17
CD56+/16- 3 - 16
CD56+/16+ 0 - 11
Inter-assay and Intra-assay
variability: 3.48 + 0.4%, respectively.
Here is the website if you want more info:
http://www.millenova.com/tests/inditests.cfmResults will take from 7-10 business days... wish me luck!
