Diagnostic Testing at Braverman IVF & Reproductive Immunology
As our knowledge of the immune system's interaction with the developing
pregnancy advance, so has our testing. Our ability to now test for and
analyze many components of the immune system has increased our ability
to correctly and accurately diagnose immune related pregnancy loss.
We do not have any Financial interest in the testing laboratory (ReproSource
labs). They are not affiliated with our practice and all financial issues
related to immunology testing must be discussed with their representatives.
We are frequently asked if patients can use other laboratories if they
run "some" of the testing that we perform. As all laboratories
use different reference ranges and we store, update, and continuously
perform relative comparisons of our patients' results, we cannot use
any testing from other laboratories.
Our testing is divided into three significant areas:
- Genetic testing: (full HLA profile) Most centers only order DQalpha or
if full HLA is ordered the genetic predispositions (so important in helping
to diagnose underlying immune issues) are not analyzed. HLA disparity
with your partner requires a full HLA analysis as well not only testing
or looking at DQalpha.
- Cellular testing: (looking at cell numbers and their propensity to make
certain cytokines, called Intra cellular cytokine ratios) Most centers
only use one cell line (CD4+ cells) to look at TNF and INFgamma and use
only IL10 as the anti-inflammatory marker in these ratios(no one looks
at the more important IL- 4 and at the production of all of these cytokines
in all of your other cells i.e. NK, NKT, and CD8+ T cells)
- Serum cytokines and antibodies: to look for the actual products made by
your white blood cells that are released into the fluid around your cells
Using all three of the above we are able to:
- Determine your predisposition to immune related problems and autoimmune
disease by studying your full HLA complement of genes(they are the finger
print of your immune system)
- Determine immune compatibility with your partner and receptivity of your
uterine immune cells.
- Determine by measuring intracellular cytokine ratios and cell numbers how
your immune system is pointing (i.e. to an TH1 or TH2 dominant state)
- Determine the level of activity of the immune system by looking at the
levels of cytokines and antibodies actually released from the cells into
the serum of the blood. (Many patients think their TNF or INFgamma ratios
that they come with from different lab are actually serum but they are
not , they are just intracellular cytokine ratios and by themselves do
NOT tell you how the immune system is responding.
Many patients email or call us and claim they have already had "full"
immune testing done and ask if they need to repeat it. We are the only
practice that has all of the testing mentioned above and have designed
the first fully comprehensive immune panel to not just look at cells but
the function of the entire immune system.
Please compare what you have had to the list below and remember without
this testing in its entirety we can NOT make a diagnosis and properly
assist you in your treatment. Isolated tests for NK cells, partial cytokine
ratios, or partial DQalpha analysis do not give complete information and
cannot be used alone.