Reproductive Immunology and Fertility: how does it affect the ability to achieve an on-going pregnancy?
In this article, Dr. Hector Izquierdo tells us how reproductive immunology affects your fertility:
- Immunology and fertility
- Causes and diagnostic tests
- Autoimmune diseases
- Solutions and treatments to achieve an on-going pregnancy
What is immunology?
Immunology is the science that studies how the human body responds to external factors to protect itself from them. These factors can be of different types, from infections, food, environmental toxins, and sometimes even our own body in cases of autoimmune diseases.
How does reproductive immunology affect fertility?
Immunology has a very close relationship with pregnancy. This is what we call reproductive immunology because it is the immune system (in communication with the embryo) that triggers the cascade of reactions that allows the embryo to implant.
After the implantation, we also need a state of tolerance from the immune system that allows the embryo to develop properly. Within this context, any imbalance in the immune system can lead to an implantation failure, a miscarriage, or pregnancy complications such as preeclampsia, hypertension, preterm birth, among many others.
What are the main immunological challenges faced by patients in assisted reproduction?
The biggest challenge is undoubtedly the lack of diagnosis because reproductive immunology is still a relatively young science within the medical field of fertility. This leads to a lot of ignorance about its impact on treatments and a lack of training in this area among fertility specialists.
The second challenge, according to Dr. Hector Izquierdo, “is the lack of research that supports the therapeutic measures we take. Despite our desires and the overall quality of our healthcare system, fertility has been somehow neglected, which means that investigations and their funding always fall into the private sector, slowing down the process itself and making information less accessible.”
Finally, due to the complexity of these tests, they are often very expensive, and since there is no public financial support for this kind of exams, accessing a diagnosis requires a financial effort that not everyone can afford.
For couples facing infertility, it is very important to undergo a study and get a proper assessment to determine if its origin is immunological.
Immunological Problems: Causes and diagnostic tests
Although there is no standard battery of tests to diagnostic immunological disorders, there is a group of pathologies associated with the risk of miscarriage and implantation failure that can be studied as a first-line approach. These include underlying autoimmune diseases and coagulation disorders.
However, not all patients have immunological disorders that affect their fertility. On the contrary, these pathologies are relatively rare.
Therefore, this diagnosis is unfortunately often made after a failed treatment when we study the causes of:
- Recurrent embryo implantation failures
- Recurrent miscarriages
- Late miscarriage or fetal loss
- Pathological pregnancy with risks for the baby or the mother
It is estimated that 10% of implantation failures or cases of recurrent miscarriages may be due to some alteration in the mother’s immune system.
What are the most common autoimmune diseases encountered in fertility clinics?
The most common immunological pathologies encountered by fertility specialists who, like us, include immunology in their diagnosis, are autoimmune diseases. To name a few, these include antiphospholipid syndrome, rheumatoid arthritis, and lupus.
At the same time, the most frequent reason for an immunological consultation is implantation failure or recurrent miscarriage. This is where the intrinsic causes associated with the immune system are investigated, and where the best fertility treatment solutions to achieve an on-going pregnancy are offered.
Autoimmune Disease and Pregnancy: Can a woman with immunological problems get pregnant?
Firstly, it is important to differentiate women’s and men’s situation when it comes to immunology. Apart from autoimmune diseases that attack the testicles and therefore reduce the quality of sperm, immunology in fertility primarily affects women, especially the embryo transfers.
In the case of a patient with an autoimmune disease, a diagnosis will be conducted prior to treatment. This is crucial for improving success rates. However, it should be noted that not all women with an autoimmune disorder will have more difficulties to conceive.
What treatments or solutions does assisted reproduction offer for immunological issues?
For a woman who has experienced gestational failures at any stage of the reproductive process, certain parameters related to general and reproductive immune function should be investigated, such as thyroid function, vitamin and/or nutritional deficiencies, insulin resistance, genital and intestinal microbiota, antibodies, autoantibodies, NK cells, HLA, TNF, regulatory T cells, Th17 cells, acquired and congenital thrombophilia, etc.
According to Dr. Izquierdo, “to solve a problem, we must first give it a name.” Every immunological diagnosis conducted aims to offer therapeutic actions that improve the situation for patients when facing embryo transfer, embryo implantation, and pregnancy monitoring.
In summary, reproductive immunology is the discipline that studies and understands the immunological processes involved in the successful development of a pregnancy, as well as diagnoses and treats dysfunctions that lead to different types of reproductive failures.
Please, feel free to contact our team of fertility specialists in Madrid or Alicante for a reliable diagnosis and information. Tell us your case, and we will help you build your family.