Our body’s immune system is composed of a a large number of of cells, molecules, and mechanisms that protect us from foreign agents, such as bacteria, viruses, and other infectious agents. But could our immune system be affecting our ability to conceive? We turned to Dr. Elena Santiago from Clinica Tambre with our questions.
Can the immune system cause infertility?
The immune system could be one of the causes of infertility due to its important participation during the process of the embryo implantation in the uterus as well as the development of a pregnancy.
What are these autoimmune disorders called?
There is not one general pathology or disorder that we can name, normally there are different disorders or immunological factors that could affect infertility. For example, thyroid alterations or autoimmunity, celiac disease, histocompatibility haplotypes and incompatibilities between men and women, increased natural killer cells, etc
Is it a common cause of infertility?
It is not one of the most common causes, but we normally find some disorders in patients who have undergone several unsuccessful treatments.
Is it hereditary?
It is not always hereditary, but some of the immunological conditions can be or are very associated with family disorders.
Is it a disorder that affects both men and women?
These are disorders that affect women due to the immunological role during implantation and pregnancy, but we sometimes have to take into account the phenotype or genotype in men to see their compatibility between the woman and the future embryo.
Are there symptoms associated with autoimmune disorders?
Not always, but yes, there can be for sure many symptoms associated with different autoimmune disorders such as celiac disease, thyroid disorders, hyper or hypo immunity, etc
If there are no symptoms, how do you know if you have an autoimmune disorder?
By testing different parameters normally in a blood sample, but also there can be other tests regarding other samples as for example endometrial biopsy.
How do you test to see if someone has an autoimmune disorder?
First of all, it is very important to have a complete anamnesis that helps to understand any previous medical condition or lifestyle that could be related to the immunological field. This will help the practitioner to suspect immunological disorders and decide which type of tests are indicated for each specific case.
Is this a test you give all patients to ensure they don’t have any underlying issues?
Normally immunological testing is not done to all fertility patients, it will depend on the case and will be indicated after several failing treatments or repeated miscarriages.
If no, when do you start testing? (After how many miscarriages/rounds of IVF?)
We usually recommend searching for immunological factors after 2 negative embryo transfers (normally Blastocysts of good quality) or after 2 miscarriages.
Can you still get pregnant with autoimmune disorders?
Yes, absolutely. The thing is that it can be more difficult for these patients to achieve an ongoing pregnancy, but if we find any disorder that could be related with implantation failure or repeated miscarriages, they will normally benefit themselves with added immunological treatments.
Does the risk of miscarriage increase?
Yes, one of the effects of immunological disorders is the possibility of increasing the risk of miscarriage. If we find out and we put a treatment for it, then we can reduce the risk.
How is immunological infertility treated?
It depends on the case and type of disorder. Most frequently there is need to use anticoagulant treatments such as aspirin or heparin. In other cases, there is need to control the immune system with steroids, cell growing factors or immunoglobulins.
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