A Complete Guide to Reproductive Immunology
The concept
of reproductive immunology is not widely accepted by all physicians.
Those patients who have had repeated miscarriages and multiple
failed IVF's find themselves exploring it's possibilities as the reason.
With an increased amount of success among treating any potential immunological
factors, the idea of reproductive immunology can no longer be overlooked.
The failure to conceive
is often due to immunologic problems that can lead to very early rejection
of the embryo, often before the pregnancy can be detected by even the
most sensitive tests. Women can often produce perfectly healthy embryos
that are lost through repeated "mini miscarriages." This most
commonly occurs in women who have a conditions such as endometriosis,
an under-active thyroid gland or in cases of so called "unexplained
infertility." It has been estimated that an immune factor may be
involved in up to 20% of couples with otherwise unexplained
infertility. These are all conditions where abnormalities of the
woman’s immune system may play an important role.
A woman’s ability
to successfully maintain a pregnancy is to a large extent dependent
upon a complex interplay of sophisticated immunologic adjustments designed
to convert her uterus
into a host for the developing embryo, the developing fetus and its
placenta from rejection. Sometimes these mechanisms can go wrong and,
depending upon how and when this happens, the woman might experience
recurrent miscarriages, infertility, or failure to conceive following
IVF
The indications
for testing are:
-
Two
miscarriages or two IVF or GIFT failures after age 35 or three miscarriages
or IVF or GIFT failure before age 35
-
Poor
egg production from a stimulated cycle (less than 6 eggs)
-
One
blighted
ovum
-
Unexplained
infertility
-
Previous
immune problems (ANA positive, rheumatoid arthritis, and/or lupus)
-
Previous
pregnancies that have shown retarded fetal growth
-
One
living child and repeat miscarriages while attempting to have a second
child
Tests used in the
immunological screening and the treatments upon findings:
Therapies and treatments
used: