Decoding Endometrial Immune Activation
Successful embryo implantation requires a precisely regulated immune environment. The maternal immune system must tolerate the embryo while remaining competent. An inappropriate immune response—either too high or too low—can lead to implantation failure.
Our Endometrial Inflammation Test (Gene Expression Panel) is a specialized molecular test designed to assess this immune status by quantifying the mRNA levels of four key genes. This is particularly crucial for patients with Recurrent Implantation Failure (RIF).
Methodology & Scientific Basis
RT-PCR Technology
Unlike microbiome analysis which uses NGS, our Gene Expression Panel utilizes Quantitative Real-Time PCR (RT-PCR). This method provides precise quantification of mRNA levels for specific immune biomarkers, allowing for an exact assessment of the inflammatory state.
Based on Pivotal Research By
Ref: "The Endometrial Immune Profiling May Positively Affect the Management of Recurrent Pregnancy Loss" - Frontiers in Immunology (2021)
The Molecular Markers
We quantify the mRNA expression of four pivotal genes to determine the IL-18/TWEAK and IL-15/Fn-14 ratios.
IL-18 / TWEAK
Interleukin-18 / TNF-like weak inducer of apoptosis
Pro-inflammatory molecules. Elevated expression indicates a high inflammatory state hostile to the embryo, potentially preventing implantation.
IL-15 / FN14
Interleukin-15 / Fibroblast growth factor-inducible 14
Regulate uterine Natural Killer (uNK) cells. Low expression suggests low immune activation or a dysfunctional response that may compromise implantation.
Profile Determination
The endometrial immune profile is defined according to the local balance of mRNA expression ratios. Based on the IL-18/TWEAK and IL-15/Fn-14 ratios, we classify the endometrial environment into four distinct profiles:
Balanced / Normal Profile
Characterized by IL-18/TWEAK and IL-15/Fn-14 mRNA ratios within the optimal range defined in fertile cohorts. This environment is receptive to implantation.
Low Immune Activation
Characterized by low mRNA ratios for IL-15/Fn-14 (reflecting immature uNK cells) or IL-18/TWEAK. This suggests an insufficient immune response to support early pregnancy.
High Immune Activation
Characterized by high mRNA ratios of IL-18/TWEAK (excess Th-1 cytokines) or IL-15/Fn-14. This indicates a hyper-inflammatory state potentially leading to embryo rejection.
Mixed Profile
Characterized by a high mRNA ratio of IL-18/TWEAK simultaneously with a low IL-15/Fn-14 ratio. This complex dysregulation reflects both inflammation and immature uNK cells.
Clinical Utility
Personalizing the Window of Implantation
The results help clinicians to better time the embryo transfer, potentially delaying it until the endometrial immune environment has been modulated through appropriate therapy.