Reader Offer – ReceptivaDx BCL6 test

What is it?

ReceptivaDx, a non-surgical test that provides enhanced screening for ALL stages of endometriosis and other conditions that interfere with implantation. The test specifically identifies BCL6, a gene repressor biomarker that is present in the setting of inflammation.

What does it do?

The test provides an indication of levels of the BCL6 protein from biopsy. BCL6 is dramatically over-expressed in women with endometriosis. This makes it a likely candidate for the cause of progesterone resistance that contributes to implantation problems.

Update

Progesterone is required for normal pregnancy. So, a protein that interferes with progesterone action would explain much about the problems encountered in women with endometriosis.

  • Elevated BCL6: Studies have shown that women with elevated BCL6 results are 5 times less likely to succeed in IVF or subsequent transfer attempts
  • Low BCL6: A negative BCL6 result provides reassurance to patients that endometriosis is not of concern.

A recent cohort study in the December 2017 issue of Fertility and Sterility1 demonstrated the prognostic value of BCL6. These results predict the likelihood of a live birth on the next IVF transfer on patients presenting with unexplained infertility before transfer.

How is the ReceptivaDx Test performed?

The ReceptivaDx Test is performed with an endometrial biopsy sample, this is sent to the accredited pathology lab. They have extensive experience in Immuno-histochemistry (IHC) testing. Results are sent back to the sending IVF centre in 3-4 days.

If positive for BCL6, what are the protocols for treatment?

Treatment protocols are typically 60-90 days of GnRH agonists like Depot Lupron(R). Followed by embryo transfer 5 to 6 days following oocyte retrieval in fresh cycles. Or during programmed oestrogen/progesterone uterine replacement cycles for frozen embryo transfers – FET cycles. Other options include surgical laparoscopy, excision or ablation of suspected endometriosis. This is then followed by management and advancement to IVF or FET.

A recently published paper in the Journal of Assisted Reproduction and Genetics2 outlines the similar success of either laparoscopy or Depot Lupron (60 days) compared to untreated positive BCL6 women. In this 7-year study, live birth rates went from around 10% in untreated patients to over 50% in treated.

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References:

  1. Almquist, Laura D. et al. 2017. Endometrial BCL6 testing for the prediction of in vitro fertilization outcomes: a cohort study. Fertility and Sterility, Volume 108, Issue 6, 1063 – 1069. December 2017
  2. Creighton E Likes, Leah J Cooper, Jessica Efird, David A Forstein, Paul B Miller, Ricardo Savaris, Bruce A Lessey. 2019. Medical or surgical treatment before embryo transfer improves outcomes in women with abnormal endometrial BCL6 expression.

 Journal of Assisted Reproduction and Genetics. Volume 36, Issue 3, pp 483–490. March 2019