When should I see a reproductive immunologist?

A Significant chunk can be the problems related to immunology. There are various antibodies in the body especially present when other autoimmune factors like diabetes, rheumatoid arthritis or such personal or family histories present. There is another entity called problem with the natural killer cells which is going to make an important part of the implantation process. There is another aspect of whether the body is able to make enough blocking antibodies which is actually basically the blocking antibodies so that the mother’s immune system doesn’t feel that the baby is a virus or a cancer and doesn’t kill it so, it accepts it. It’s very intriguing how nature has designed it that there is a whole another body inside a body and then it is accepted but when this mechanism fails and when the body recognizes a new antigen as something foreign and rejects it so, definitely all those undiagnosed patients can be missed and they are again put in the box called unexplained. I do practice reproductive immunology, there are very few doctors who practice reproductive immunology to the extent that we do but we do it very carefully in a very rightly selected small group of patients in our whole practice. I take at least one hour explaining to the patient why now they qualify for this kind of therapy because this therapy has not gained enough evidence because it is very expensive to do these studies and with time we will have them but it is not there yet.

Well, an interesting and smart question I would say because the answer is if the couple don’t want to get prosecuted by having many IVF trials, they should start consulting immunologists but why?
To check first of all the quality of the egg because if we perform, for example, all the immunological tests and we do the treatment of the lady for the immune status to be regulated before the IVF trial and we have the successful pregnancy but later on we have unpleasant miscarriage because we didn’t check the quality of the wife’s egg and that also will lead to another IVF trial – so it’s very important to test, before the consultation for the immunological test: the quality of the wife’s egg.
How do we do that?
Basically most of the gynaecologists, even here in Greece and in European Union they check only for AMH the Anti-Müllerian hormone but AMH when the age increases of the lady and becomes 38, 39, 40, 41, 42 – this automatically, we know from the bibliography, that it will decrease the reserve volume of the ovaries – that doesn’t mean though that the lady doesn’t have quality of eggs.
How do we check this?
We test certainly and specifically and it’s strictly we determine the day of how we draw blood from the lady at the third day of her cycle – we test for Inhibin B. InhibinB is the test that tells us the quality of the eggs and we have also draw a specific number – if it’s above this number, then it can have decent or okay quality of eggs but if it’s below this number in picograms per ml, then we think that the lady is going close to menopause. That means then we have to stimulate her with natural products – we have some techniques to do that. If she responds and increases the quantity of Inhibin B and automatically will increase the quality of eggs, then we tell that she can go with her own eggs for the next IVF trial otherwise we tell her you’re going to menopause you have to go with a donor egg in order to have a successful pregnancy.