Infertility is caused by many medical conditions and diseases. Autoimmune disease can cause major problems with fertility. If you have been diagnosed with an autoimmune defect, discuss your options for pregnancy with your fertility doctor.
What is the purpose of the immune system?
The immune system defends the body from organisms and intruders. With an autoimmune disease, the body attacks its own cells, as there is a defect in the immune system. The immune system protects against disease, with the main defenders being the white blood cells (WBCs), which destroy invading organisms. The T cells destroy intruders tagged with antibodies. When the body produces antibodies, these substances remain in the body and attack the intruder again.
How do autoimmune diseases affect fertility?
When a woman with an autoimmune disease becomes pregnant, the body attacks the developing fetal cells, as it would an invading organism. The embryo is often destroyed by the cells produced by the immune system. Additionally, certain medications prescribed for autoimmune disease can affect fertility. Cytoxan (cyclophosphamides) is associated with miscarriages.
Is pregnancy possible if you are diagnosed with an autoimmune disease?
A woman can maintain a pregnancy with an autoimmune disease, but you should communicate with the doctor to establish a plan for the developing baby. It is best to become pregnant when the disease is in remission. While pregnant, the autoimmune disease may flare-up, but this can be controlled with medications.
What medications can be given during pregnancy?
To control a flare-up of an autoimmune disease, anti-inflammatory agents are often used. Prednisone is a corticosteroid agent that suppresses immune system activity, and aspirin decreases swelling that often accompanies an autoimmune disease. While safe to use during conception, prednisone should be avoided if possible during the first trimester. Steroid use has been associated with low birth-weight infants, but there are no major fetal complications related to use of these drugs.
What specific autoimmune diseases impact fertility?
Difficulty conceiving is no pregnancy after a full 12 months of unprotected intercourse. Recurrent pregnancy loss (RPL) is more than three miscarriages. Around 80 autoimmune conditions that can affect female and male fertility. Common diseases associated with problems conceiving and recurrent pregnancy loss include:
• Type 1 diabetes – This endocrine disease is characterized by lack of insulin production.
• Systemic lupus erythematosus (SLE) – This life-long disease affects various parts of the body, including the lungs, heart, and skin. There are many situations that makes the disease worse.
• Anti-phosopholipid syndrome
• Elevated anti-nuclear antibody (ANA)
• Rheumatoid arthritis (RA) – Characterized by joint pain and swelling, this condition can cause problems with ambulation and movement.
• Scleroderma – Also called systemic sclerosis, this rare disease causes the skin to thicken, get hard, and contract.
• Sjorgen’s syndrome – This condition usually starts out with dry mouth, and leads to muscle and joint problems.
• Hashimoto’s thyroiditis – The immune system attacks the thyroid, which does not produce adequate amounts of thyroid hormone.
Do fertility drugs cause flare-ups of autoimmune symptoms?
During specific times in the menstrual cycle, many women report flares of autoimmune symptoms. Since fertility drugs are hormones, they too can produce flare-ups of various symptoms. It is important that the fertility specialist work closely with your rheumatologist or endocrinologist to offer the most-effective, safest, and best-tolerated combination of medications.
What types of immune tests will the fertility specialist do?
There are two types of immune tests done by the fertility specialist. The antisperm antibody test is used to detect certain antibodies made by the man’s immune system. Around one-third of infertility is the result of male problems, such as when the man cannot produce functioning sperm or deliver sperm appropriately. Another test is for killer cells, which attack the developing embryo as if it were a dangerous organism. This test is done through biopsy of the uterus lining (endometrium).