Immunological Investigations
In compliance with an EC directive screening for Hepatitis B and C, HIV and syphilis infection is repeated with every new IVF/ICSI attempt, in order to be able to work with guaranteed infection free cells in the laboratory. |
Routine blood test [blood test | Outpatient Clinic]
During your initial consultation at the CRG, and in every fertility treatment case, a blood sample will be taken. Tests will not only be performed to obtain information regarding hormones, but also to detect any infections which might be present.
Tests will be performed to detect the presence of antibodies to HIV, hepatitis B & C, syphilis, CMV (cytomegla virus), rubella and toxoplasmosis. The latter two can cause serious damage to the embryo during the early stages of pregnancy.
The presence of antibodies in the blood indicates that that person is or has at some time been infected with the disease in question, or that they have been vaccinated against it. It is possible to be vaccinated against rubella before attempting to become pregnant, but sadly not for toxoplasmosis.
Examination of the Cervix [consultation | lab]
The first consultation will usually include a gynaecological examination for the woman, unless she has had a recent one elsewhere. A cervical smear or PAP-test will be performed, which involves the removal of a small amount of cervical mucus for examination.
- The smear test can indicate whether you are at risk of developing cervical cancer.
- The mucus is also examined for the presence of infections such as ureaplasma, mycoplasma and others.
Antibodies to spermSometimes a woman's body makes anitbodies to sperm. The body regards sperm cells as undesirable intruders and goes about getting rid of them. The antibodies are produced by white blood cells, which attach themselves to the sperm cell, causing them to stick together. As a result, they lose their motility and are thus unable to reach the egg..
It is also possible for a man to produce antibodies against his own sperm, which means that his body attacks his own sperm. See
immunological investigations for men.
The presence of antibodies can be determined by blood tests, but sometimes sperm and cervical mucus are mixed together under laboratory conditions to see how well the sperm is able to penetrate the mucus.
TAT (Tray-Agglutination test) or friberg test [blood test | lab andrology]So named after the man who invented the test, this involves the combining of your blood with (anonymous) sperm cells to see if agglutinated antibodies are present.
'Agglutination' means 'tangle together' which immediately indicates the limitations of the test. It doesn't specifically concern the presence of antibodies alone and regularly produces innaccurate results.
Therefore if this test indicates that you produce antibodies to sperm, it will be necessary to have the result verified by performing an SCMC-test (see below). You can download the instruction sheet
here.
Sperm & cervical mucus contact test (SCMC-test) [consultation & sperm sample| lab andrology]
The purpose of this test is the same as the previous one, namely to establish whether or not your body produces antibodies against sperm cells. However, it makes it much easier to evaluate the way in which your partners' sperm interacts with your cervical mucus, hence the name of the test. The test is performed around the thirteenth day of the menstrual cycle. In preparation, you may need to take hormone medication for a few days to support your cycle. You can download the instruction sheet
here or obtain it from your doctor or counsellor.
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SCMC: sperm cells penetrate the cervical mucus |
Just before the procedure, an amount of mucus will be removed from your cervix. Your partner will then have to produce a sperm sample. He may be allowed to produce it at home as long as you can keep it at room temperature and ensure that it arrives at the lab within an hour.
Under laboratory conditions, the sperm and mucus are put together in a dish and the sperms' level of motility is observed, to see if it remains normal.
This sort of test is sometimes performed prior to artificial insemination with donor sperm. In this case, cervical mucus from the woman is mixed with the (thawed) sperm sample of the potential donor.
Postcoital test (Sims-Huhner test) [consultation | lab andrology] In theory, this test sounds simple. After sexual intercourse you have a gynaecological examination, during which a small amount of cervical mucus is removed. This mucus is examined in the lab for the presence of motile sperm.
In practice however, it is not so simple to organize. Sexual intercourse must take place eight hours before the test. Apart from that, a number of procedures have to be carried out in advance, such as blood tests and ultrasound scans of the endometrium (womb lining) and above all establishing whether it is a good time in your cycle to perform the test. Lastly, the results of the test are not always 100% accurate. You can also download the
instruction sheet for this test.