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Autoimmune disease and infertility
Autoimmune disease occurs when the body’s immune system mistakenly attacks its own healthy tissues.
This might affect fertility in both men and women.
How does autoimmune disease affect fertility?
- In a healthy pregnancy the body must accept the embryo and support its growth.
- In autoimmune disease abnormal immune response may interfere with ovulation, implantation, embryo development or pregnancy maintenance.
Some autoimmune conditions may:
- Affect ovarian function
- Affect egg quality
- Increase inflammation in the reproductive organs
- Interfere with embryo implantation
- Raise risk of recurrent miscarriage
- Affect hormonal balance
- Affect menstrual cycles
Thyroid autoimmune disorders:
- Hashimoto thyroiditis and graves’ disease
Systemic lupus erythematosus:
Affects fertility through:
- Inflammation
- Medication
- Complications related to pregnancy
Antiphospholipid syndrome:
Leads to:
- Recurrent pregnancy loss
- Implantation failure
- Abnormal blood clotting
Rheumatoid arthritis:
- Chronic inflammation
- Some harmful medications
Endometriosis:
- Has autoimmune component
- Leads to chronic inflammation which affect fertility
IVF challenges related to autoimmune disease:
- Inflammation related problems with implantation
When to suspect autoimmune disease as a cause of pregnancy complication/infertility:
- Recurrent miscarriage
- Unexplained infertility
- Associated systemic manifestations
Evaluation of autoimmune disease include:
- Thyroid function tests
- Autoimmune antibody screen
- Hormonal tests
- Ultrasound examinations
- Thrombophilia screen
Medications to be given when autoimmunity is suspected to be the cause of infertility:
Immune modulating medications such as:
- Prednisolone
- Progesterone supplements
- Vitamins and antioxidants
- Intralipid
- Aspirin and anticoagulants
Many patients with autoimmune disease conceive and deliver healthy babies with proper medical care. Care should be multidisciplinary.
Dr Najeeb Layyous F.R.C.O.G
Consultant Obstetrician, Gynecologist and Infertility Specialist
