Women’s Health & Infertility

  • HHV-6 in Infertility

    Human herpesvirus 6 (HHV-6) is suspected to be involved in several types of gestational complications, including spontaneous abortions, gestational hypertension and preterm birth. According to a study published in PLOS Pathogens (Marci R, et al, 2016) HHV-6A is found in 43% of women with unexplained infertility. The ability of HHV-6 to disrupt the uterine environment and fetal development may result in infertility and pregnancy loss. The virus can only be detected in uterine epithelial cells and not in blood samples using traditional HHV-6 testing methods.

    Coppe Laboratories’ TRAc-6 testing for HHV-6 has proven to be the most sensitive method for detection of active viral replication in tissue samples. With the growing evidence of an association between HHV- 6 and infertility, we recommend testing endometrial tissue from patients presenting with unexplained infertility, repeat failure to implant and multiple miscarriages.

    References

    1. Marci R et al. (2016) Presence of HHV-6A in Endometrial Epithelial Cells from Women with Primary Unexplained Infertility. PLoS ONE 11(7): e0158304.
    1. Eliassen et al. Med Hypotheses. 2017 May;102:41-47.


    Arthropod-borne Disease in Pregnancy

    During the 2015 outbreak of Zika virus infections in Brazil it was discovered that Zika virus infection during pregnancy places the fetus at risk of developing birth defects. Recent studies have shown that Zika may not be the only arthropod-borne virus that can cause abnormalities in babies born to infected mothers. Other closely-related viruses, primarily mosquito-borne West Nile virus and tick-borne Powassan virus, demonstrate the ability to cause a range of mild to severe brain damage in the fetuses of mice infected during pregnancy. Powassan and West Nile virus were also found to infect and replicate readily in human maternal and fetal placental tissue samples.

    Coppe Laboratories offers antibody testing for West Nile virus and the only commercially-available array of tests for Powassan. The CDC recommends screening pregnant women who suspect they may have had exposure to Zika virus at each prenatal visit. Coppe Laboratories is the only commercial lab that offers prenatal screening tests for West Nile and Powassan virus in the US.

    Another recent paper examined two case studies of congenital Babesia infection that prompted new questions about tick-borne infections in pregnancy. In both cases, the mothers were diagnosed with Lyme disease during their second trimester of pregnancy. Both were treated with antibiotics and recovered. Their babies were born full term, and neither had any evidence of Lyme, consistent with previous studies that show Lyme disease can be successfully treated during pregnancy without fetal complications. Unfortunately, both babies contracted congenital Babesia infections, forcing these weeks old infants into 5-10 day hospital stays in order to receive necessary treatment. In retrospect it was discovered that both mothers had acquired subclinical Babesia infections during pregnancy which were not diagnosed or treated. Any woman with a suspected tick exposure during pregnancy should be tested for Lyme disease, Babesia and Powassan to avoid fetal developmental abnormalities and complications for newborns.

    References

    1. D.J. Platt et al., “Zika virus–related neurotropic flaviviruses infect human placental explants and cause fetal demise in mice,” Sci Transl Med, doi:10.1126/scitranslmed.aao7090, 2018.
    2. Saetre et al. Congenital Babesiosis After Maternal Infection With Borrelia burgdorferi and Babesia microti. Journal of the Pediatric Infectious Diseases Society, pix074,https://doi.org/10.1093/jpids/pix074.