Our Concept

We offer specialized diagnostics of uterine natural killer cells, uterine plasma cells, uterine regulatory T-cells and the BCL6 expression
in the endometrium.

Endometrial biopsy

The endometrial biopsies are analyzed by immunohistochemistry on formalin-preserved tissue. By using specific antibodies, uterine natural killer cells (CD56-positive), plasma cells (CD138-positive) or regulatory T-Cells (FOXP3-positive) can be displayed and their tissue abundance can be evaluated.

Uterine natural killer cells

Uterine natural killer cells are immune cells that play an important role in the second half of the cycle (luteal phase) and in early pregnancy. They are called "killer" due to their ability to target viruses and bacteria as well as tumor cells.

Uterine plasma cells

Uterine plasma cells accumulate in the endometrium in the setting of chronic inflammation. Chronic inflammation may present without any symptoms or can be marked by irregular bleedings, pelvic pain or increased vaginal discharge. Plasma cells can be detected by immunostaining with the antibody CD138.

Uterine regulatory T-cells

Regulatory T cells belong to the group of T lymphocytes and play a central role in the self-regulation of the immune system. Uterine regulatory T cells regulate the activity of the immune system and can promote tolerance towards the embryo.

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Endometrial BCL6 Expression

BCL6 is a biomarker of inflammation, progesterone resistance and endometrial dysfunction. Increased expression is associated with reduced chances of successful fertility therapy, endometriosis, recurrent miscarriage and implantation failure.

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Therapeutic options

To date, there are no approved immunological therapies targeting natural killer cells in patients with recurrent miscarriage or recurrent implantation failure. Different treatment options are currently under investigation in international studies. These options include glucocorticoids (e.g., prednisolone), lipid infusions (e.g., Intralipid®) and immunoglobulins. In the light of other immunological changes as seen in idiopathic implantation failure or idiopathic (= no apparent cause) recurrent miscarriage, G-CSF (granocyte®), chloroquine or TNF blocker are being evaluated in clinical studies.
If the goal of immunomodulatory treatment like lipid infusions is the reduction of peripheral and / or uterine natural killer cells, initiation of therapy may be useful even before pregnancy or in the cycle before IVF / ICSI treatment.

Procedure

Contact

Ask your doctor about the possibility of an endometrial biopsy.

When to obtain the endometrial biopsy

We currently recommend a biopsy between the 5th and 10th day after ovulation (this corresponds to the 19th and 24th day of the cycle in a regular 28-day cycle). The analysis of plasma cells can also be performed at the beginning of the cycle after menstruation.

Sample shipment

Your tissue should be shipped directly to our laboratory in Mannheim.

Communication of your report

The medical report is sent directly to your physician (within 5 working days after we receive the sample).
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