Autoimmune disease and infertility

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