Immunological Fertility Testing When the Body Misinterprets Pregnancy

Maintaining a pregnancy after conception requires absolute collaboration and balance between the embryo and the mother's immune system. In some women, this system, instead of protecting the new beginning, may inadvertently treat it as an "intruder." Immunological causes of infertility are one of the most contemporary — yet misunderstood — aspects of reproductive medicine. At FertUlity, we believe that the immune system should be trained — not suppressed. Through specialized tests such as KIR, ImMAP, and NK cell analysis, we can determine whether such a misinterpretation by the body exists and propose targeted, personalized treatment solutions.

What Immunological Testing Includes?

Fertility immune testing is not a simple, general blood test, but a combination of specialized markers that analyze how the body perceives and responds to embryo implantation and pregnancy in general. It includes both genetic and hematological / cytological analyses, performed via blood sampling or endometrial tissue collection, depending on the case.

These tests are based on the following markers

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KIR Typing (Killer-cell Immunoglobulin-like Receptors)

These are genetic receptors of natural killer (NK) cells. Determining the mother’s KIR gene type requires a simple blood test. If the KIR genes of the mother and the HLA-C type of the embryo are incompatible, the risk of miscarriage or implantation failure may increase.

NK Cells (Natural Killer Cells)

NK cells are part of the innate immune system. Their count and activity are also assessed through a blood sample. In some cases, they may overreact to the presence of the embryo, triggering inflammation or even rejection. Measuring their concentration and activity can reveal a "hidden" barrier.

ImMAP Profiling

This is a pioneering test requiring an endometrial sample taken via a thin catheter in the clinic in just a few minutes. ImMAP Profiling analyzes cytokines, inflammatory markers, and the overall immune profile of the endometrium. It is used to determine whether the endometrium is “receptive” or if further support is needed. The combination of results from the above markers offers a holistic view of the immunological status, enabling us to accurately design the appropriate treatment protocol.

When Immunological Testing is Indicated

Immunological testing is not recommended in all cases but becomes necessary when there are signs that the natural immune balance has been disrupted. It is particularly useful for couples who have experienced repeated implantation failures (RIF) after in vitro fertilization (IVF), or in cases of recurrent miscarriage, where other possible causes have been ruled out. Additionally, when increased inflammatory activity in the endometrium is observed or when no genetic, hormonal, or anatomical reasons can explain the difficulty in conception, immune testing may provide the crucial answers needed to design an effective treatment strategy.

How Immunological Barriers Are Treated

The treatment approach focuses not on suppression but on restoring immune system balance.

Depending on test findings, the following interventions may be applied:

Intralipids (intravenous lipid emulsions) to regulate NK cell activity

Cortisone in controlled dosage to reduce inflammation

Sitagliptin or other immunomodulating agents

Endometrial support with cytokines or growth factors

Personalized IVF protocol based on KIR/HLA-C compatibility between mother and embryo

The goal is to establish a balanced immune profile that will support implantation and pregnancy continuation. With accurate diagnosis and immune regulation, the chances of successful implantation and full-term pregnancy are significantly increased.

Frequently Asked Questions About Immunological Fertility Testing

Is it safe to regulate the immune system?

Absolutely. The interventions are mild and targeted, aiming not to suppress the body's defense system but to adapt it for a balanced reproductive environment.

On which day of the cycle should the tests be done?

The timing depends on the test. Blood tests (e.g., KIR, NK cells) can be done on any day, while endometrial sampling for ImMAP profiling is usually performed in the second phase of the cycle (7th to 9th day after ovulation) to provide a reliable picture of the endometrial response.

Is the procedure painful?

Blood tests are entirely painless. Endometrial biopsy may cause mild discomfort similar to a period cramp and lasts less than 2 minutes.

Are follow-up tests required?

In many cases, immune testing is done only once. If there’s a significant change in inflammatory or immune status (e.g., after treatment), a follow-up may be requested to confirm improvement.

Can I have an immune issue and not know it?

Yes. Most immune-related barriers are "silent" and present no symptoms. They are typically detected only when there are unexplained implantation failures or miscarriages that are thoroughly investigated.

Our Doctors

In an era where fertility requires knowledge, care, and substantial guidance, FertUlity is not an impersonal clinic. It is two people who look you in the eye and accompany you step by step on the journey you dream of.

Dr. Maria Oikonomou Obstetrician – Gynecologist

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Dr. Chrysostomos (Makis) Papadopoulos Obstetrician – Gynecologist, MD, PhDc, MIC I

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