The endometrium suffers periodic changes during the menstrual cycle destined to achieve a state of optimal receptivity that allows an adequate embryonic implantation. The embryo can adhere to the endometrium only during this short period of time, known as the implantation window (WOI). WOI occurs between days 19-21 of the menstrual cycle, 7 days after the endogenous LH peak (LH + 7) in a natural cycle, or 5.5 days after the first dose of progesterone (P+ 5.5) in a cycle replaced. However, there are exceptions in which your WOI is displaced from this position for various reasons, since this window is personal in each woman and can be influenced by genetic inheritance, age and environmental factors. In fact, there are numerous studies that have shown that the inability of this tissue to establish a receptive phenotype is a very common cause of infertility. Therefore, it is essential to know when the implantation window is open in each woman, that is, when her endometrium is receptive and ready to receive an embryo
Likewise, the endometrium is the only human tissue with the ability to regenerate and revascularize monthly during the entire fertile life of the woman. This biological effort has the objective of sensing the state of female health. Thanks to the cells and molecules of the immune system that regenerate in this mucosa, if any potential threat is detected, the endometrium will be able to modulate the functionality to prevent pregnancy. However, when the functionality of the endometrium is affected by the onset of symptomatic or asymptomatic inflammatory processes such as endometriosis, autoimmunity, infections and metabolic factors, receptivity could also be modified. In this context, infertility becomes a natural defense of a woman's body because her body is potentially compromised and not fit enough to develop and carry a pregnancy to term
For this reason, today genetic and immunological factors become more relevant to researchers. Therefore, it is essential to have a comprehensive study to establish whether the causes of reproductive failures are associated with a displacement of their WOI and / or modification of the immune status that affects both functionality and receptivity.
WHAT IS THIS TEST?
FERT&i is a dual and comprehensive study of endometrial functionality and receptivity. It consists of a single test capable of analyzing the endometrium in an integrated manner by combining the determination of receptivity through its transcriptomics with an analysis of the immune status that defines the functional potential of endometrial tissue. The FERT&i study allows establishing the impact at the endometrial level of systemic inflammatory causes that may affect the receptivity and functionality of this tissue.
Who has an indication of this test?
- Patients diagnosed with chronic inflammatory diseases (autoimmune, metabolic, polycystic ov., endometriosis)
- Patients with infertility without apparent cause
- Patients with repeated abortions without apparent cause or with Antiphospholipid
- Patients with alterations in uterine perfusion
WHAT IS THE METHODOLOGY?
This comprehensive study is carried out through a single endometrial biopsy, 7 days after the peak of LH in the natural cycle or 5.5 days after taking progesterone, when a higher probability of finding a receptive endometrium is detected. Said sample is separated into two tubes with different preservation media and is sent to our laboratory, where we analyze the transcriptomic material by means of a quantitative microfluidic PCR system that combines the technology of the microarrays with the PCR technique in real time. Besides, through flow cytometry, the count of populations and subpopulations of NK cells, macrophages and lymphocytes related to the immunological factor that intervene in the endometrium is performed. In a maximum time of 3 weeks, the specialist is sent a detailed report with the interpretation of the results obtained.
BENEFITS OFFERED BY FERT&i
- FERT&i allows to provide a comprehensive diagnosis of endometrial receptivity (PRE-RECEPTIVE, RECEPTIVE OR POSRECEPTIVE) and state of the patient's immune system (INFLAMMATORY, NORMAL OR NON-FUNCTIONAL).
- If an inflammatory or non-functional result is obtained, they can be evaluated clinically and treated by a team of specialized immunologists and endocrinologists.
- Inmunogenesis offers advice in immunology directly to the Fertility specialist or to the patient; through a series of consultations for the request of complementary studies, initiation of treatment, control and follow-up.
- Through its diagnostic platform and a personalized treatment, the objective is to return the endometrium to the possibility of recomposing its immunological balance, increasing the chances of implantation of the embryo and reducing the probability of suffering a spontaneous abortion, leading to a full-term pregnancy.