My pleasure. Please go to www.millenova.com and download their order form online. The main test to order is called NK assay test and runs approximately $300. This can be drawn at your local 1ary doctor or OB-GYN and the blood sent to Chicago. Please note that I have no financial affiliations to this lab. They are one of three reproductive immunology labs that do the appropriate testing. Unfortunately, contracted labs like LabCorp and Quest do not. If the test is +, then I recommend you get an opinion from our SIRM in NY. also see below:
Patients with endometriosis have immunologic abnormalities. The most significant of these involve the presence of harmful antibodies known as antiphospholipid antibodies (APA) which are in the bloodstream of about 66 percent of women with endometriosis. In about half such cases (i.e. about 1/3 of all cases of endometriosis…regardless of severity) the immunologic implantation is profoundly aggravated by the presence of activated (i.e “toxic”) Natural Killer cells (Nka) in the uterine lining (endometrium). These NKa attack the invading trophoblast cells (developing "root system" of the embryo/early conceptus) as soon as it tries to gain attachment to the uterine wall. In most cases, this results in death of the embryo even before the pregnancy is diagnosed and sometimes, in a chemical pregnancy or even an early miscarriage. . As such, many women with endometriosis, rather than being infertile, in the strict sense of the word, often actually experience repeated undetected “mini-miscarriages”. Treatment requires prior and specific identification of all 18 sub-types and their gammaglobulin isotypes. Unfortunately, only a handful of Laboratories in the United States are capable of adequately testing for APAs. But it probably not APAs that cause infertility in endometriosis patients. Rather it is the co-existence of toxic or activated NK cells (Nka) that attack the early embryo’s root system as soon as it tries to attach to the uterine wall that causes the problem. The presence of APAs probably represents a marker which identifies those endometriosis patients who have immunologic problems requiring immunotherapy Women with APA's experience improved IVF birth rates when mini-dose heparin is administered from the onset of ovarian stimulation with gonadotropins (Repronex, Gonal F, Bravelle or Follistim) until the 8th week of pregnancy.
ENDOMETRIOSIS AND IMMUNOLOGIC IMPLANTATION FAILURE.
Recently we discovered that heparin therapy alone, only benefits APA+ women who do not have positive blood tests for Nka while women who test positive for Nka require intravenous immunoglobulin (IVIG) or intralipid therapy.