Medical advancements are giving people a wide range of diagnostic tests that can help uncover underlying conditions. The area of fertility is no different. In the 40 plus years since the first IVF baby was born, advancements to diagnose chromosome abnormalities through preimplantation genetic testing, uncover underlying structural issues with high definition ultrasound, and many other improvements in egg retrievals, egg freezing and thawing have all improved the success rates of IVF. Yet failure is still relatively high hovering just above 55 percent. One new area of testing focuses on the endometrium where the embryo is transplanted in IVF. Previous IVF failure history or recurrent pregnancy loss are good indicators that something may be wrong with the endometrium.A test that has become more routine in IVF centers in recent years is the ReceptivaDx test. It uses an endometrial biopsy and can detect inflammation on the uterine lining that is highly associated with endometriosis. Women who have gone through various fertility treatments without success may find the answers they are looking for with this test.
What is BCL6?
Before we get into the implications of high levels of BCL6 let’s first understand what BCL6 is. BCL6 is a protein marker that identifies uterine inflammation most often associated with asymptomatic (silent) endometriosis. BCL6 is found in more than 50% of women with unexplained infertility and 65% of women with two or more IVF failures.
Understanding the ReceptivaDx test results
ReceptivaDx evaluates the expression of this protein and the lab provides a full pathology report identifying a score interpreted as positive or negative. From these results, your doctor will have significant insights used to determine the receptivity of the uterus for an embryo implantation/transfer.
Having High BCL6 Levels
High BCL6 levels suggests the presence of endometriosis. Positive results indicate inflammation of the uterine lining most likely caused by the body’s immune response to endometriosis. The test has been validated to be 93% sensitive and 96% specific for the presence of endometriosis. This inflammatory condition has proven to impact implantation and/or cause early pregnancy loss. Endometriosis is also associated with progesterone resistance thus negating even trigger shot therapies for many women. A positive result allows doctors to further investigate and evaluate the endometrium for the next transfer.
Treatment
If ReceptivaDx results do reveal high levels of BCL6, your doctor will receive a full pathology report and it is recommended to get a comprehensive evaluation from a reproductive specialist. They can then devise an individualized treatment plan. Treatment options for a positive BCL6 include hormone suppression and surgery designed to reduce or remove the endometriosis optimizing fertility outcome. Left untreated, studies show patients with positive BCL6 have less than a 12% chance for success on the next transfer cycle. However, with treatment, the probability of success jumps up to over 60% on the next transfer. Patients with a negative result typically indicate the uterine lining is likely to be receptive. Other conditions may be impacting failure.
Conclusion
A positive result for high levels of BCL6 after taking the ReceptivaDx test can provide valuable information during the IVF process. It can indicate inflammation on the uterine lining which is highly associated with endometriosis, a condition that can make it difficult to get pregnant and stay pregnant. With the knowledge gained from a ReceptivaDx test, your healthcare provider can optimize your fertility plan and increase your chances of a successful pregnancy.