Im Map® is our specific immunological test. It determines the endometrium’s immune cell subpopulations and identifies alterations in these subpopulations in medical conditions associated with implantation failure or recurrent spontaneous abortion. We must determine these alterations to establish immunotherapy treatments to restore the endometrial immune profile and increase the probability of a successful pregnancy.
Los factores inmunológicos son causa de muchos casos de infertilidad de origen desconocido. Im Map®

Im Map®

Immunology Map

The cells of the maternal immune system represent a major cellular component that actively participates in the physiological changes in the uterus for implantation, placentation, and foetal growth. These immune cells have phenotypic and functional characteristics that promote foetal recognition and tolerance and protect the pregnant mother and the embryo from possible infections. Dysregulation of the immune balance in the maternal endometrium and, consequently, maternal-foetal tolerance are related to pregnancy complications, such as implantation failure, recurrent miscarriages, and preeclampsia.

Im Map® is our specific immunological test. It determines the endometrium’s immune cell subpopulations and identifies alterations in these subpopulations in medical conditions associated with implantation failure or recurrent spontaneous abortion. We must determine these alterations to establish immunotherapy treatments to restore the endometrial immune profile and increase the probability of a successful pregnancy.

Process
Immunological factors are cause of many cases of unexplained infertility Im Map®

 

Biopsy of endometrial
tissue P+5.5 /LH+7
Introduction in the
Im Map® cryotube
Refrigeration
immediately at 4ºC
Sample shipment
at 4ºC
Análisis de los<br />
niveles de células inmunitarias
Analysis of immune
cell levels
Resultados en 15<br />
días hábiles
Results in 15
working days
inmunoterapia
inmunoterapia
Process
Immunological factors are cause of many cases of unexplained infertility Im Map®
Im Map® es nuestro test inmunitario específico dirigido a determinar las subpoblaciones inmunitarias presentes en el endometrio y a identificar alteraciones de éstas observadas en condiciones médicas asociadas a fallo de implantación o aborto espontáneo recurrente. La determinación de alteraciones permitirá establecer un tratamiento de inmunoterapia dirigido a restablecer el perfil inmunitario endometrial e incrementar la probabilidad de éxito en el embarazo.

Improve your chances of pregnancy

YOUR PROCESS

Add quality and confidence to your assisted reproduction treatment: go one step further and include the Im Map® test in your process.

1.

Tell your gynaecologist, he or she will show you how Im Map® can make a difference.

2.

Your doctor will find the right option for you.

3.

Your doctor will take care of everything so that we can continue to look after you as you deserve in your journey towards motherhood.

Reproductive Immunology

Reproductive immunology is the scientific discipline that focuses on studying reproductive pathologies with an immunological basis. The immune system is composed of a complex network of cells and molecules with specific morphological and functional characteristics that promote the correct implantation of the embryo through the secretion of cellular components and their interaction with endometrial and embryonic cells.

Before and during implantation, immune cells participate in three essential processes: uterine vascular and tissue remodelling, regulating the inflammatory/anti-inflammatory balance, and foetal tolerance. Dysregulation in the adaptive changes of the endometrium’s immune system can cause pregnancy complications such as implantation failures or recurrent spontaneous abortion. In turn, incorrect immunosuppressive treatment can increase foetal risk and pregnant patients’ susceptibility to infection.

The Im Map® test identifies the different immune subpopulations in the endometrium so that alterations in their levels can be detected, offering patients a specific immunotherapy treatment that restores the immune balance in the endometrium and increases foetal tolerance, implantation, and the probability of successful pregnancy.

Tissue and vascular remodelling

Immune cells present in the endometrium are essential for the correct regulation of trophoblastic invasion, tissue remodelling, angiogenesis, and embryo growth. These processes are carried out through the specific secretion of factors stimulating fetal growth and tissue and vascular remodelling.

It has been shown that an alteration in the levels and activation of the immune subpopulations is related to an alteration in vascular and tissue remodelling causing implantation failure, spontaneous miscarriages, as well as pre-eclampsia, premature births, and fetal growth restriction^1,2 .

Pro-inflammatory/anti-inflammatory balance

Immune cells secrete small proteins called cytokines that regulate the inflammatory state of the endometrium. These can be categorised into pro-inflammatory cytokines that act as active agents in the induction of the immune response, and anti-inflammatory cytokines that regulate this response. The synthesis of both cytokines allows for the establishment of the pro-inflammatory/anti-inflammatory balance present in the endometrium during the implantation window.

The study of the pro-inflammatory/anti-inflammatory balance is essential, as, for successful implantation, the maternal endometrium must exhibit a specific inflammatory state that promotes this process. Indeed, deregulation of the pro-inflammatory/anti-inflammatory balance has been linked to pregnancy loss, preterm birth, or preeclampsia^3. Additionally, other studies have shown that women with recurrent miscarriages have increased levels of pro-inflammatory cytokine-producing cells compared to women who have successful pregnancies^4,5,6.

Foetal tolerance

The embryo expresses paternal components that can be recognised by the maternal immune system and that may lead to the rejection of the embryo during pregnancy. To ensure reproductive success, the endometrial maternal-foetal interface exhibits a distinctive immune profile that promotes immunosuppression and ensures foetal tolerance and survival 7.

Several studies have shown alterations in the immune subpopulations that play a role in regulating the immune response and, consequently, an alteration in tolerance, in patients who have experienced spontaneous miscarriages during the first trimester 8.

How do we perform the Im Map® tests?

ImMap® is carried out through an endometrial biopsy in the luteal phase for diagnosis.

The endometrial biopsy sample can be obtained concurrently with the biopsy for our endometrial receptivity analysis test, ER Map®, on LH+7 in a natural cycle, P+5.5 in a substituted cycle, and hCG+7 in a modified natural cycle.

The samples are analysed using multiparametric flow cytometry. Flow cytometry is a biophysical technology used to detect immunological markers and to conduct a count of cellular populations.

This technique allows for the simultaneous multiparametric analysis of the physical and chemical characteristics of millions of cells within minutes. In cases where abnormal levels of immune cells are detected, various immunotherapy options suitable for each patient may be offered.

  1. Quenby S. et al. – Fertil Steril 2005, 84(4), 980–984.
    2. Tuckerman E. et al. – Hum reprod 2007; 22: 2208-2213.
    3. Saito S. et al. – Am J Reprod Immunol 2010 63(6), 601–610.
    4. Kwak-Kim J.Y.H. et al. – Hum Reprod 2003; 18(4): 767-773.
  1. Nakagawa K. et al. – Reprod Med Biol. 2017(16), 297-301.
    6. 5. Nakagawa K. et al. – Am J Reprod Immunol. 2019(82), e12142.
    7. Sadeghpour S. et al. – Immunopharmacology and immunotoxicology. 2020; 42: 632-642.
    8. Rafiee M. et al. Iran J. Immunol 2015 (12): 251-262.