Unexplained Infertility, Sperm Allergies,
Natural Killer Cells & Autoimmune Problems
Unexplained Infertility
Make sure your doctor rules out these medical conditions before you accept a diagnosis of unexplained infertility:
Anatomical issues:
Sperm Allergy
The most common immune system problem affecting fertility is an allergy to sperm. In many cases of unexplained infertility, the mystery can be solved by a test for antisperm antibodies. These antibodies are proteins the immune system uses to identify and protect itself against foreign intruders. A woman’s body can make antibodies to her partner’s sperm, killing or disabling them as soon as they get into the cervical mucus.
Estimates range from 5 to 25% of couples with fertility problems have this condition, which is treatable. The only way to know whether you or your partner have antisperm antibodies, is to have an “immunobead binding” test. Ask your doctor. Source: BabyCenter
Natural Killer Cells & Autoimmune Problems
This is a controversial subject.
Believers
Dr. Alan Beer was a pioneer in the field of reproductive medicine who died in 1996. According to Dr. Beer, up to 80 percent of problems with infertility are caused by autoimmune problems such as lupus, Crohn’s disease, rheumatoid arthritis, chronic fatigue, allergies and thyroid problems.
Proponents believe that some couples produce embryos that are misinterpreted by the immune system as foreign objects or even cancer cells. These embryos are rejected by the woman’s body and each attempt at pregnancy makes the problem worse, including IVF.
According to Beers, there are four main types of immune problems in women with recurrent pregnancy loss: antithyroid antibodies, antiphospholipid antibodies (thrombophilias), antinuclear antibodies and “Natural Killer Cells.” These conditions cause the body to mistakenly attack normal cells as if they were invaders. They can lead to poor blood flow, lack of nutrition to a fetus, interference with implantation or early miscarriage.
If you are experiencing unexplained infertility, recurrent miscarriages, or chemical pregnancies but don’t know why, ask your doctor about getting a blood test for Antiphospholipid antibodies (APAs). APAs show up in about 15 percent of women with recurrent miscarriages. Your doctor will probably prescribe daily low-dose aspirin or an anticoagulant blood thinner such as heparin or Lovenox to reduce the risk of blood clots and miscarriage.
Women who have had repeated miscarriages, early pregnancy losses, or failed IVF cycles should be evaluated for more serious clotting disorders, including thrombophilia, overactive clotting. In this case you should see a Hematologist.
Despite the name, Natural Killer Cells are actually present in every woman’s uterus, and have an important role in immune system responses to viral infections as well as during implantation. Natural Killer Cells may also be a cause of recurrent miscarriages, however. In some women, these cells overreact to a pregnancy, attacking the embryo the same way they attack cancer cells. A simple blood test can determine whether your Natural Killer cells are working too hard. Some doctors recommend intravenous gamma globulins, steroids, or intralipid infusions to suppress the immune system just long enough to get pregnancy established (usually through the first three months), though not all fertility specialists take this approach or even test for NK cells.
Antinuclear antibodies exist to attack the nuclei of cells invading your body. They can sometimes attack a fertilized egg too, if it is mistaken for an invader. People with autoimmune diseases such as Lupus and Rheumatoid Arthritis tend to have high levels of these antibodies, which can lead to inflammation in the uterus and placenta, implantation failure, recurrent miscarriages, or unexplained infertility. Women with high levels of antinuclear antibodies also have less success with IVF. If you are having trouble getting pregnant, discuss with your doctor having the simple blood test that measures your level of antinuclear antibodies. Standard treatment is a steroid such as prednisone to suppress inflammatory and immune response, lowering the level of antibodies. If your level is very high, you should also see a Rheumatologist.
According to Dr. Beer’s center, in one study of 47 women with various immunologic abnormalities and an average age of 37 years old, a low dose of IVIg was given two weeks before anticipated conception and continued through either 12 or 30 weeks of pregnancy. In this study 75 percent of treated women had successful pregnancies, whereas the 7 women who did not use IVIg therapy all miscarried.
You can be tested for autoimmune and natural killer cell levels remotely by The Alan E. Beer Center for Reproductive Immunology & Genetics.
Sources: The Sun, Gov.UK , NKCells
Non-believers
According to the National Institutes of Health, the scientific rationale for these tests and treatments is not supported by current knowledge of the function of uterine Natural Killer cells. Unfortunately, our understanding of the role of the immune system in implantation and pregnancy is very rudimentary at this point.
The majority of reproductive endocrinologists do not support administration of these drugs to women, even if they have been told they have increased Natural Killer cell activity in their blood stream. There is no widely accepted scientific explanation of any benefits these treatments may have in reproductive medicine. These treatments are not licensed for use in reproductive medicine. As with all medical interventions they carry risks and potential side effects. You should learn all about the risks of these treatments to you and your fetus. You should only receive treatment after giving fully informed consent. Sources: PacificFertilityCenter, NIH
Natural Killer Cells & Autoimmune Problems
Unexplained Infertility
Make sure your doctor rules out these medical conditions before you accept a diagnosis of unexplained infertility:
- Adrenal disorders: Ovarian, pituitary, or adrenal tumors
- Pituitary disease, dysfunction, or failure
- Hyperandrogenism Galactorrhea-amenorrhea syndrome Hypothalamic-pituitary amenorrhea (usually associated with extreme stress and weight loss or bulimia)
- Hyperinsulinemia Resistant ovary syndrome
- High levels of insulin
- Blood test for estrogen and FSH and LH
- Cervical mucus culture (postcoital)
- Serial progesterone blood test to check for luteal phase defect
- Blood test for prolactin (check for pituitary issues)
- Blood test for Thyroid imbalance
- Blood test of testosterone and DHEA
- Blood test for fasting glucose and insulin levels for PCOS
Anatomical issues:
- Blocked fallopian tubes
- Adhesions
- Fibroids
- Endometriosis
- Ovarian Cysts
- Stenotic Cervix
- Asherman’s Syndrome
- Culture of cervix for bacteria, a routine check for infection (such as mycoplasma) which can cause infertility or early pregnancy loss
Sperm Allergy
The most common immune system problem affecting fertility is an allergy to sperm. In many cases of unexplained infertility, the mystery can be solved by a test for antisperm antibodies. These antibodies are proteins the immune system uses to identify and protect itself against foreign intruders. A woman’s body can make antibodies to her partner’s sperm, killing or disabling them as soon as they get into the cervical mucus.
Estimates range from 5 to 25% of couples with fertility problems have this condition, which is treatable. The only way to know whether you or your partner have antisperm antibodies, is to have an “immunobead binding” test. Ask your doctor. Source: BabyCenter
Natural Killer Cells & Autoimmune Problems
This is a controversial subject.
Believers
Dr. Alan Beer was a pioneer in the field of reproductive medicine who died in 1996. According to Dr. Beer, up to 80 percent of problems with infertility are caused by autoimmune problems such as lupus, Crohn’s disease, rheumatoid arthritis, chronic fatigue, allergies and thyroid problems.
Proponents believe that some couples produce embryos that are misinterpreted by the immune system as foreign objects or even cancer cells. These embryos are rejected by the woman’s body and each attempt at pregnancy makes the problem worse, including IVF.
According to Beers, there are four main types of immune problems in women with recurrent pregnancy loss: antithyroid antibodies, antiphospholipid antibodies (thrombophilias), antinuclear antibodies and “Natural Killer Cells.” These conditions cause the body to mistakenly attack normal cells as if they were invaders. They can lead to poor blood flow, lack of nutrition to a fetus, interference with implantation or early miscarriage.
If you are experiencing unexplained infertility, recurrent miscarriages, or chemical pregnancies but don’t know why, ask your doctor about getting a blood test for Antiphospholipid antibodies (APAs). APAs show up in about 15 percent of women with recurrent miscarriages. Your doctor will probably prescribe daily low-dose aspirin or an anticoagulant blood thinner such as heparin or Lovenox to reduce the risk of blood clots and miscarriage.
Women who have had repeated miscarriages, early pregnancy losses, or failed IVF cycles should be evaluated for more serious clotting disorders, including thrombophilia, overactive clotting. In this case you should see a Hematologist.
Despite the name, Natural Killer Cells are actually present in every woman’s uterus, and have an important role in immune system responses to viral infections as well as during implantation. Natural Killer Cells may also be a cause of recurrent miscarriages, however. In some women, these cells overreact to a pregnancy, attacking the embryo the same way they attack cancer cells. A simple blood test can determine whether your Natural Killer cells are working too hard. Some doctors recommend intravenous gamma globulins, steroids, or intralipid infusions to suppress the immune system just long enough to get pregnancy established (usually through the first three months), though not all fertility specialists take this approach or even test for NK cells.
Antinuclear antibodies exist to attack the nuclei of cells invading your body. They can sometimes attack a fertilized egg too, if it is mistaken for an invader. People with autoimmune diseases such as Lupus and Rheumatoid Arthritis tend to have high levels of these antibodies, which can lead to inflammation in the uterus and placenta, implantation failure, recurrent miscarriages, or unexplained infertility. Women with high levels of antinuclear antibodies also have less success with IVF. If you are having trouble getting pregnant, discuss with your doctor having the simple blood test that measures your level of antinuclear antibodies. Standard treatment is a steroid such as prednisone to suppress inflammatory and immune response, lowering the level of antibodies. If your level is very high, you should also see a Rheumatologist.
According to Dr. Beer’s center, in one study of 47 women with various immunologic abnormalities and an average age of 37 years old, a low dose of IVIg was given two weeks before anticipated conception and continued through either 12 or 30 weeks of pregnancy. In this study 75 percent of treated women had successful pregnancies, whereas the 7 women who did not use IVIg therapy all miscarried.
You can be tested for autoimmune and natural killer cell levels remotely by The Alan E. Beer Center for Reproductive Immunology & Genetics.
Sources: The Sun, Gov.UK , NKCells
Non-believers
According to the National Institutes of Health, the scientific rationale for these tests and treatments is not supported by current knowledge of the function of uterine Natural Killer cells. Unfortunately, our understanding of the role of the immune system in implantation and pregnancy is very rudimentary at this point.
The majority of reproductive endocrinologists do not support administration of these drugs to women, even if they have been told they have increased Natural Killer cell activity in their blood stream. There is no widely accepted scientific explanation of any benefits these treatments may have in reproductive medicine. These treatments are not licensed for use in reproductive medicine. As with all medical interventions they carry risks and potential side effects. You should learn all about the risks of these treatments to you and your fetus. You should only receive treatment after giving fully informed consent. Sources: PacificFertilityCenter, NIH