Test de inmunología reproductiva
Test de inmunología reproductiva

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

Analysis of immune
cells levels

Results in 15
working days

Immunotherapy

Process

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

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 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

The immune cells in the endometrium are essential for properly regulating trophoblast invasion, tissue remodelling, angiogenesis, and embryo growth. These processes are carried out through the specific secretion of factors that stimulate foetal growth and tissue and vascular remodelling.

An alteration in the levels and the activation of immune subpopulations have been shown to be related to an alteration in vascular and tissue remodelling, causing implantation failure, miscarriages, as well as preeclampsia, premature births, and foetal growth restriction (1- 2).

Pro-inflammatory/anti-inflammatory balance

Immune cells secrete small proteins called cytokines that regulate the inflammatory state of the endometrium. Cytokines can be classified into pro-inflammatory cytokines that act as active agents in the induction of the immune response, and anti-inflammatory cytokines, which regulate said response. The synthesis of both classes of cytokines will establish the endometrium’s pro-inflammatory/anti-inflammatory balance during the implantation window.

The study of the pro-inflammatory/anti-inflammatory balance is essential because successful implantation requires a specific inflammatory state in the maternal endometrium that promotes this process. In fact, dysregulation of the pro-inflammatory/anti-inflammatory balance has been associated with pregnancy loss, premature birth, or preeclampsia (3). Moreover, other studies have shown that women with recurrent abortions have increased levels of proinflammatory 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 cause rejection of the embryo during pregnancy. The endometrial maternal-foetal interface presents a characteristic immune profile that promotes immunosuppression and guarantees foetal tolerance and survival for reproductive success (7).

Several studies have shown how an alteration in the immune subpopulations is involved in regulating the immune response, and consequently, these studies show an alteration in tolerance in patients who have suffered miscarriages during the first trimester (8).

How do we perform the Im Map® tests?

ImMap® uses an endometrial biopsy taken during the luteal phase for diagnosis.

The endometrial biopsy can be obtained in parallel with the biopsy from our ER Map® endometrial receptivity assay test at LH+7 for a natural cycle, P+5.5 for a substituted cycle, and hCG+7 for a modified natural cycle.

The samples are analysed by multiparametric flow cytometry. Flow cytometry is a biophysical technology used to detect immunological markers and count cell populations.

This technique simultaneously performs a multiparametric analysis of the physical and chemical characteristics of millions of cells in only a few minutes. In cases where abnormal levels of immune cells are detected, several types of immunotherapies are available, suitable for each patient’s needs.

These immunological treatments can help improve patients’ reproductive outcome, increasing the chances of embryo implantation and reducing the possibility of suffering a miscarriage.

  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.