Diagnostic Testing at Braverman IVF & Reproductive Immunology
Through decades of rigorous research and clinical experience, we have arrived at the conclusion that surgical intervention is the most effective treatment for addressing the inflammatory and autoimmune responses associated with endometriosis and adenomyosis. Extensive studies have shown that these conditions are intricately linked to immune-related fertility challenges. As such, targeting the underlying immune response through surgery offers a promising approach to improving fertility outcomes in affected individuals.
We have found that testing is divided into three significant areas:
1. 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.
2. 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)
3. 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 (the serum).
Using all three of the above enables you to:
1. 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)
2. Determine immune compatibility with your partner and receptivity of your uterine immune cells.
3. Determine by measuring intracellular cytokine ratios and cell numbers how your immune system is pointing (i.e. to an TH1 or TH2 dominant state)
4. 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.
Our decades of research and clinical study underscore the critical need for a targeted approach to treating endometriosis and adenomyosis, particularly in addressing the inflammatory and autoimmune responses that are closely linked to immune-related fertility challenges.
The evidence we have gathered strongly supports the role of surgical intervention as an effective means to not only alleviate the symptoms but also to enhance fertility outcomes for affected individuals.
As our understanding of these conditions deepens, it is clear that surgical intervention stands as a pivotal treatment, offering hope and improved outcomes for those struggling with infertility due to these complex disorders.
If you are interested in learning more about Endometriosis and its crucial role in Fertility and Miscarriages, please visit our Endometriosis website for more information and Request a Consultation with a member of our Medical Team or schedule an In-Person Visit with Dr. Vidali.