Communication between embryo and uterus
Immunological problems are definitely causes of recurrent failed implantation and pre-implantation pregnancy loss. It is necessary for the uterus to accept and tolerate the implanted embryo.
Both the embryo and the maternal uterine environment communicate with each other through proteins found in the cells of the uterine lining (cytokines). If there is not correct communication to the embryo from the cytokines in the uterus or if the uterus does not recognize the signals of the embryo, then there will likely be a problem with adhesion and implantation.
Diagnosing the issues
In order to treat this condition effectively, it is important that a correct diagnosis is established. Since pre-implantation pregnancy loss occurs after the egg is fertilized and before it is implanted, it can be the result of problems with the egg or with the sperm.
If it is the egg, the problem can be diminished ovarian reserve or premature ovarian failure. Diagnostic testing for these conditions includes follicle stimulating hormone (FSH) testing and testing for antiovarian antibodies (AOA).
When there are sperm problems that haven't been detected with standard semen analysis, then other, more extensive testing can be done.
· Sperm DNA Integrity assay (SDIa) measures DNA damage in sperm. Standard semen analysis which includes sperm concentration, motility or morphology, does not include the markers of sperm quality used to predict pregnancy outcome in their parameters. An SDIa is the test used to get those results.
· Y chromosome microdeletion assay discovers the genetic condition of microdeletions in the Y chromosome that results in no sperm or very low sperm counts. The importance in identifying men with Y chromosome deletions is because the deletions can be transmitted by ICSI injections.