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.
tissue P+5.5 /LH+7
Im Map® cryotube
immediately at 4ºC
Improve your chances of pregnancy
Add quality and confidence to your assisted reproduction treatment: go one step further and include the Im Map® test in your process.
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
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).
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).
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?
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.
- 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.
- 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.