BCL-6 Test and Endometriosis: All You Need to Know

The BCL-6 test is a new test that can help clinicians identify patients with possible endometriosis or potential infertility.

What is BCL-6 and its role in endometriosis?

Researchers identified BCL-6 (B-cell lymphoma 6) as an oncogene or a gene that may affect the development of cancer. This gene plays a role in cell development, cell death, and inflammation. Research has shown that an excess of the protein that this gene encodes, increases various inflammatory cytokines and can alter the immune environment.

More recent work has shown that the BCL-6 protein is overexpressed during the secretory phase of the menstrual cycle in women with endometriosis. The levels of BCL-6 were also high in a significant number of women with unexplained infertility. Many of these women eventually received a diagnosis of endometriosis via laparoscopy.

Therefore, some physicians are using high BCL-6 values as an important predictor of possible endometriosis and poor IVF outcomes.

How does it work?

Your OB/GYN can perform a BCL-6 test, which involves an endometrial biopsy during an office visit. You will undergo a routine speculum exam and may experience brief cramping or pain during and after the procedure. You can pre-medicate with over the counter pain medication.

Your doctor will typically take the biopsy 7 to 10 days after ovulation (during the luteal phase) or after about four days following increased luteinizing hormone (LH) levels. He or she will help with the timing of the biopsy or may give you medication to simulate this phase if your periods are not regular.

The ReceptivaDx Test will be sent out and processed to look for the BCL-6 protein marker and the results will usually become available within a week.

What is the cost of a BCL-6 test?

The ReceptivaDx BCL-6 test kit costs US $690. Your healthcare provider may choose to add additional biomarkers for testing depending on your clinical situation.

For instance, CD-138 is a marker that is useful in diagnosing endometritis (inflammation of the endometrium) and can be added for an additional US$145.

Check with your center for the exact requirements and for the most up-to-date pricing.

What are the implications of undergoing BCL-6 testing and what do the results mean?

A positive BCL-6 test result points to the presence of inflammation in the uterine lining. Researchers think that this inflammation affects reproductive outcomes and leads to infertility (difficulty conceiving spontaneously after 12 months).

The most common association is with endometriosis. Patients can then follow up with their healthcare providers, who may recommend further treatment options such as laparoscopy. If so, we recommend deep excision surgery

Is BCL-6 testing a complete diagnostic tool for endometriosis?

No. BCL-6 testing is a merely a clinical tool and must be implemented by the correct provider in the right clinical setting. It is particularly useful to confirm silent endometriosis. Here, women may have recurrent miscarriages but no other symptoms.

While BCL-6 results can be prognostic, laparoscopic excision surgery followed by a histological examination is the only way to confirm a diagnosis of endometriosis.

I’ve tested positive for BCL-6. Am I infertile?

A skilled surgeon can remove endometriosis and decrease inflammation using laparoscopic deep excision surgery. At Seckin Endometriosis Center (SEC), we believe that this is the best approach and can give a woman her best chance of spontaneous or assisted fertility.

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