20 Apr Autoimmune Factors that Affect Fertility
Around 50 million people in the U.S. suffer from autoimmune conditions. Around 75% of these diseases affect women. Hormones are thought to contribute to these conditions, and other suspected triggers are environmental toxins, genetics, and viruses. Infertility can be caused by certain autoimmune diseases.
When a woman with an autoimmune disease gets pregnant, her body attacks the developing fetal cells, just as it would invading microorganisms. The embryo can be destroyed by the immune system cells. In addition, certain autoimmune medications are associated with miscarriages, such as cyclophosphamides (Cytoxan).
The immune system defends the body from intruders and organisms. With the autoimmune disease, the body will attack its own cells. The main defenders produced by the immune system are the white blood cells (WBCs), which destroy invading organisms. When intruders are tagged with antibodies, the T cells destroy them. Antibodies also remain in the body so they can attack the intruder again.
Medications for Autoimmune Disease
A woman can carry a pregnancy if she has an autoimmune disease, but she should communicate with the doctor beforehand. It is best to get pregnant when the disease is in remission. During the pregnancy, the autoimmune disease can flare-up, but it is often controlled with medications. During certain times of a woman’s menstrual cycle, autoimmune system symptoms flare-up. Fertility drugs are hormones so they also produce flare-ups of symptoms. The fertility specialist works with the rheumatologist and endocrinologist to offer the safest, most-effective, and best-tolerated regimen of medications.
To control flare-ups of the autoimmune disease, anti-inflammatory agents are used. Prednisone is a corticosteroid drug used to suppress the immune system activity. In addition, aspirin can be given to decrease swelling. These drugs are safe to use during conception, but prednisone should be avoided when possible during the first three months (first trimester). Steroid use is associated with low birth weight babies, but the drug does not cause any major fetal complications.
Specific Autoimmune Diseases that Impact Fertility
Trouble conceiving after a full 12 months of unprotected sexual intercourse is considered infertility. Recurrent pregnancy loss (RPL) is three miscarriages consequently. More than 80 autoimmune disorders affect male and female infertility. The most common are:
- Type 1 diabetes – This is an endocrine disease characterized by insufficient insulin production.
- Systemic lupus erythematosus (SLE) – This chronic disease affects the lungs, heart, and skin.
- Rheumatoid arthritis – This disease causes joint pain, inflammation, and swelling.
- Scleroderma – This rare disease makes the skin get hard, thicken and contract.
- Sjorgen’s syndrome – This condition causes major joint and muscle problems.
- Hashimoto’s thyroiditis – The immune system attacks the thyroid with this condition, and inadequate amounts of thyroid hormone are produced.
- Antiphospholipid syndrome – With this condition, the woman has abnormal antibodies to blood-vessel wall components, such as serine, cardiolipin, and ethanolamine. This causes abnormal clotting and recurrent pregnancy loss.
If the fertility specialist suspects an autoimmune disorder, he or she will order an anti-sperm antibody test, which is used to detect certain antibodies made by the male partner’s immune system. Approximately one-third of infertility is caused by a male factor, such as inadequate functioning sperm or low sperm count. Another test performed checks for killer cells, which will attack the developing embryo as if it is a dangerous invader. The fertility specialist must conduct a biopsy of the endometrium (uterine lining) for this test.