ÚPMD / Reproduction immunology workplace

Department head

MUDr. Jindřich Madar, CSc.
telephone and fax: 296 511 387
e-mail: jindrich.madar@upmd.cz

Ambulance-orders (13.00 - 14.30):

telephone: 296 511 388

Description of activity

The Department of Reproductive Immunology (DRI) of the Institute for the Care of Mother and Child is one of the 3 specialized workplaces in Czech Republic, which is concerned with the immunological conditions of malfunction of fertility. It is already known for many years that one of the basic conditions of successful conception and termination of pregnancy is the "immunological tolerance" - immunological compatibility from mother’s side. It is not at all surprising - spermatozoa and consequently the embryo are foreign to the mother's immunity and without special "preventive measures" could be mercilessly liquidated by immunity.

In recent years it appears that in the significant part (almost 50% are discussed) of cases of malfunction of fertility, incorrectly directed immunity in the female genital tract plays a significant role. It relates to the disability to become pregnant and also to terminate the pregnancy successfully.

A large amount of new knowledge in this direction is derived from the analysis of failed transfers of quality embryos after in vitro fertilization (IVF).

What is examined

The DRI examines both partners. The basic point in the first examination is the case history: the doctor inquires about a possible genetic stress and immunity defects in the family members, of the whole health state of the partner, especially concerning immunity malfunction, of fetal implantation defects, and duration of fertility, and attempts at treatment. (laparoscopy, hysteroscopy, hormonal examination, insemination, IVF.) The laboratory part of the examination involves immunity deposition tests both generally and targeted in relation to fertility. If the case the hormone levels are tested - especially function of the thyroid gland that can significantly influence women fertility.

Antibodies bound to the surface of spermatozoa in man (these changes cause significant greater immunological irritation to the partner) and a detailed spermiogram is executed. If it is desirable, DRI executes a range of other tests (immunological analysis of mucus of the uterine cervix, test of penetration of the spermatozoa through the cervical mucus and other things.) Wider spectrum of examination methods is allowed by a close cooperation with the complex of Central laboratories of the Institute and with other external specialized workplaces.

It the DRI doctor finds a defect in immunity, which could affect embryo implantation and development, a suitable therapeutic regime is recommended to the patient’s attending physician. Treatment results are then analyzed at control examinations in DRI.

Results

The examination in DRI was conducted in a sum of 11812 couples with malfunction of fertility by June 30, 2010. Of these there were in 52.7% immunological causes of infertility were discovered. (most often increased specific cell-mediated immunity in female genitalia, furthermore, the presence of antibodies on the partner’s spermatozoa, an increased amount of cardiolipin antibodies in women’s blood among other things.)

At present, DRI has more than 900 addresses of cooperating doctors from the whole Czech Republic and also from abroad. Thus, the information about successful results of pregnancy often does not reach DRI. Nevertheless, many patients send a notification or a photo of the baby and it must be said that such a report is a stimulant for DRI workers.

DRI is a workplace or co-workplace of research grants and takes part in the realization of research projects in UPMD. Its workers publish in professional journals, actively participate in scientific congresses, and are involved in the teaching of medical students and in postgraduate education.

More information about the department of reproductive immunology can be found on: http://www.neplodnost.org