RIC for Clinicians
Pregnancy and the Immune System
From implantation of the fertilised egg to the delivery of a healthy baby, the maternal immune system has a major impact on the development of the foetus and its survival in the immunologically hostile maternal environment. For successful pregnancy, the mother's immune system has to tolerate the immunologically foreign foetus.
The inability of a healthy woman to get pregnant or suffer recurrent miscarriage has a number of causes. These include chromosomal/genetic abnormalities, uterine problems and endometrial infection amongst others. When these have been excluded, exaggerated maternal immune activity is considered of prime importance. This may involve either the antibody and coagulation system in cases of the anti-phospholipid antibody syndrome or NK and T cells when the cellular immune system is overly active. Checking for increased or abnormal activity of these cells and the exclusion of autoimmunity allows timely pharmacological intervention that is critical for reproductive success.
The Reproductive Immunology Centre
The Reproductive Immunology Centre (RIC) is based in Croydon and offers a comprehensive laboratory assessment of NK and T cell function as well as other immunological parameters in women with unexplained infertility.
RIC is well established and is only one of three laboratories in the world that provides in depth analysis of the immune system in the field of infertility. Our services are used by many fertility specialists around the country as well as several other laboratories lacking our expertise.
An extremely important characteristic of RIC is our programme of on going research. This builds on many years of earlier work that has been published in several peer reviewed journals and which supports the benefit that our tests offer the clinician in the investigation of unexplained infertility. A list of publications by RIC personnel can be seen on the Research and Development page. We are currently investigating the importance of Th17 and T regulatory cells in infertility and recurrent miscarriage. If you are interested in collaborating with us, please contact us.
Tests available at RIC
We have a wide repertoire of tests which includes:
- NK cytotoxicity
- Assessment of the suppressive effect of steroid, IVIg and intralipid on NK cell killing
- NK CD69 assay
- Th1/Th2 cytokine assay
- Anti Nuclear Antibody
- Anti Thyroid Antibodies
- Anti Cardiolipin Antibodies ( both IgG and IgM)
- Lymphocyte subsets
- Factor V Leiden Mutation
- Prothrombin Gene Mutation
We are also working on the development of a test to enumerate Th17 cells and T regulatory cells.
Accessing the Testing Service
We aim to offer the easiest service for you and your patients.
We are able to provide a London location for phlebotomy if needed, as well as couriers to get the sample to us. A map of the phlebotomy site is available here.
Results can be faxed back within 2 days for NK and T cell based assays, if required.
Sample Requirements
| NK cytotoxicity | 2 x 6mL Lithium Heparin samples |
| NK suppression test | 2 x 6mL Lithium Heparin samples |
| NK CD69 assay | 1 x 6mL Lithium Heparin sample |
| Th1/Th2 cytokine assay | 1 x 6mL Lithium Heparin sample |
The above assays need to arrive in the laboratory within 8 hours of collection and have been kept at room temperature.
| Anti Nuclear Antibodies | 1 x Clotted sample |
| Anti Thyroid Antibodies | 1 x Clotted sample |
| Anti Cardiolipin Antibodies | 1 x Clotted sample |
| Factor V Leiden Mutation | 1 x EDTA sample |
| Prothrombin Gene Mutation | 1 x EDTA sample |
| Lymphocyte Subsets | 1 x EDTA sample |
Samples need to be clearly labelled with the patient's name, date of birth and another identifier such as a hospital number. The date and time of sample collection should also be clearly indicated. All samples should be accompanied by a fully completed request form that has the patient details and the name and address of the requesting clinician, as well as the tests required. If the results are to be faxed, a fax number must be provided.
Obtaining Results
We can email results and provide hard copies by post.
Clinic Testing Costs
The price of the NK cell test and other reproductive immunology test can be obtained from the Prices and Payment page.
Unfortunately infertility treatment is almost never covered by private insurance and RIC is not aware of any of the leading UK private insurance companies supporting the cost of the tests or of the subsequent treatment.
Guidance on Interpretation of Test Results
It is important that a clinician familiar with the tests should interpret the results. An interpretation sheet can be provided along with the result.
Download RIC for Clinicians Leaflet
Download a printer-friendly version of the RIC for Clinicians leaflet, to read and refer to at your convenience.