What Questions Should You Ask About Immunological Testing and Treatments?

1. Is My Pelvis Structurally Normal?

Before jumping into immune testing, we first evaluate whether your pelvis is completely normal. If you have conditions like

• Fibroids
• Endometriosis
• Adenomyosis

…these need to be treated first. A uterus affected by structural issues cannot support a pregnancy well, no matter what immune treatments you get.

🔍 Important Insight: In India, many clinics offering immunology work as commercial units without operating theater (OT) facilities or surgical expertise. This means they often mistreat pelvic causes, leading to delayed or failed outcomes.

2. Could There Be Another Predictable Cause for My Pregnancy Loss or Implantation Failure?

In more than 90% of cases, we can identify a clear cause that may not even be related to immune factors:

• Poor egg quality
• Poor sperm quality
• Genetically abnormal embryo (not tested through PGT-A)

Without checking these basics, we may be missing the most obvious reasons.

3. If an Immune Deficit Is Found, Is It Correctable?

Let’s say some abnormal immune markers are found. The next question should be: Can it be treated?

Most tests in immunology assess pro-inflammatory markers in your blood or uterine lining, such as:

• NK cells
• CD56 ratio
• TH1/TH2 ratio

But these tests are usually qualitative—they don’t offer black-and-white answers. That’s why expert interpretation is essential.

4. Could There Be a Genetic Cause?

Have you and your partner had a consanguineous marriage (related by blood)? If yes, the chance of genetic abnormalities goes up.

You may need:

• Karyotyping
• Genetic screening of embryos (PGT-M or PGT-A)

These tests help rule out inherited issues that could cause recurrent miscarriages or implantation failures.

5. What Is the Expected Outcome of Immunological Therapy?

Let’s be honest: immune-based treatments do not guarantee success.

Especially in India, where patients are spending out-of-pocket, expectations are naturally high. But the truth is:

• Immune therapies have limited evidence-based success rates
• We often cannot explain the exact reason behind a miscarriage or failed IVF

So always ask: What’s the likely outcome in my exact situation? Be informed, not just hopeful.

6. Does Immunological Therapy Apply If I’m Using Donor Eggs, Donor Sperm, or Surrogacy?

If your fertility journey includes:

• Donor eggs
• Donor sperm
• Surrogacy (uterus donation)

…then immune therapies typically don’t apply. That’s because these treatments are most useful when you’re using your own eggs and sperm.

These are the most common questions which you as a couple should be trying to think about or ask your immunology specialist.