Role of Immunological Testing in Infertility

Unexplained infertility, recurrent pregnancy loss, and recurrent implantation failure are challenging clinical scenarios, both for patients and providers. The role of immunologic testing for these conditions is an area of new and expanding research. This review presents the current, existing evidence on the role of immunological testing in infertility. A number of different immunological tests for infertility are available, including antiphospholipid antibodies, antithyroid antibodies, antinuclear antibodies, endometrial studies, uterine natural killer cells, systemic natural killer cells, Th1/Th2 cells, and Th17/regulatory T cells. There has been tremendous variation in the use of these tests for infertility and recurrent pregnancy loss, likely driven by a lack of consensus on their utility. Our review concludes that there are significant limitations to immunological testing in this setting. Larger, prospective studies are needed prior to mass adoption of many immunologic tests.