Frequently Asked Questions

1. Who should be tested for immunologic causes of reproductive failure?
2. How does immunologic testing help with infertility treatment?
3. How effective are these treatment regimens?
4. Do I need a physician to order tests?
5. Can patients receive results directly without going through a physician?
6. When should I have my blood drawn?
7. What if my Day 3 bloods need to be drawn over the weekend?
8. Can I have my NK activity (NKa) test or my Reproductive Immunophenotype (RIP) drawn on the weekend along with my Day 3 bloods?
9. I live out of state or out of country, how do I send the laboratory my blood?
10. Is your laboratory contracted with any insurance companies?
11. What credit cards do you accept?
12. What insurance companies cover our tests?
13. How do I get reimbursed from my insurance company for the laboratory testing?
14. Does Millenova provide documents to insurance companies to support the medical necessity of these tests?
15. How long will it take to get the results of my tests back?
16. Does Millenova offer the new sperm DNA test?

Q. Who should be tested for immunologic causes of reproductive failure?

A. All women experiencing two or more recurrent pregnancy losses, unexplained infertility, infertility associated with endometriosis and those with a history or family history of autoimmune disease including lupus erythematosus, collagen or vascular disease, or thyroid disease.

Q. How does immunologic testing help with infertility treatment?

A. An immunologic cause for infertility has been suggested for a large number of women who have otherwise unexplained infertility. Of couples with unexplained infertility or IVF/implantation failure, approximately

• 30 to 40% will have an autoimmune component, demonstrated by the presence of antiphospholipd, antinuclear or antithyroid antibodies.
• 20 to 25% will have an elevation of circulating natural killer cells or an elevation in natural killer cell activity.

Q. How effective are these treatment regimens?

A. While effective treatments for an immunologic cause of established recurrent pregnancy are now widely accepted, treatment for unexplained infertility or IVF implantation failure has been controversial. This controversy can be largely explained by the fact that the patient populations, as well as the clinical and laboratory methodologies, varied greatly. For example, all but two studies on antibodies and the benefit of heparin treatment among women evaluated the effect of antiphospholipid antibodies in women undergoing IVF for both male and female causes of infertility. Sher et. al. showed that the increased frequency of antiphospholipids was confined to women experiencing female causes of infertility. This observation makes sense because there is no biologic plausibility for an effect of antiphospholipid antibodies with isolated male factor.

Q. Do I need a physician to order tests?

A. Yes. You may ask your infertility doctor or primary care physician to order and receive results. Dr. Coulam is available to your physician to discuss the results. Alternatively, you may make an appointment for consultation with Dr. Coulam and she can order the tests for you. Once the consultation and tests are done and the results are available, Dr. Coulam can go over the results of the tests with you. An appointment for consultation with Dr. Coulam may be obtained by calling (312) 573-1900.

Q. Can patients receive results directly without going through a physician?

A. No, all test results are sent directly to the requesting physician's office.

Q. When should I have my blood drawn?

A. Most of the immunologic tests may be drawn at any time during the menstrual cycle with the exception of the Day 3 blood for ovarian reserve including Inhibin B, Follicle Stimulating Hormone, and estradiol. Blood should be drawn Monday through Thursday and shipped priority mail to Millenova Immunology Laboratories.

Q. What if my Day 3 bloods need to be drawn over the weekend?

A. Have your blood drawn on the weekend. The facility drawing the blood will need to spin the sample and separate the serum for freezing. Please make sure the serum is properly labeled and shipped on Monday for overnight delivery.

Q. Can I have my NK activity (NKa) test or my Reproductive Immunophenotype (RIP) drawn on the weekend along with my Day 3 bloods?

A. No. Although your Day 3 bloods can be drawn, separated and frozen on the weekend, the NKa and RIP tests need viable cells from whole blood sent in green top tubes. The cells are only viable for approximately 24 hours. Your blood needs to be drawn Monday through Thursday and shipped overnight delivery.

Q. I live out of state or out of country, how do I send the laboratory my blood?

A. Contact Millenova Immunology Laboratories Client Services at (312) 274-1928 and they will provide you with the necessary shipping supplies you'll need as well as information on how to send your blood and the costs.

Q. Is your laboratory contracted with any insurance companies?

A. No. All blood samples need to be sent with payment enclosed. Checks or credit cards are accepted.

Q. What credit cards do you accept?

A. We accept VISA or MasterCard.

Q. What insurance companies cover your tests?

A. Most insurance companies cover these diagnostic tests. However, every insurance company is different. Each has several levels of coverage with specific requirements and stipulations regarding specific diagnoses. If there are questions, you should check directly with your insurance company.

Q. How do I get reimbursed from my insurance company for the laboratory testing?

A. After payment is processed a receipt will be mailed to you. You can submit this receipt to your insurance company for reimbursement.

Q. Does Millenova provide documents to insurance companies to support the medical necessity of these tests?

A. Yes. Contact Client Services at (312) 274-1928 for these documents.

Q.Does Millenova offer the new sperm DNA test?

A. Yes, the Sperm DNA Integrity (SDI) test. Click here for more informaiton.

Q. How long will it take to get the results of my tests back?

A. The turn around time for test results is 7 to 10 days upon receipt of your blood. As the results are completed, they will be faxed immediately to your physician.