Immune system disorders
How these may affect fertility
Immune system disorders and autoimmune diseases may affect your chances to conceive (men and women). Pregnancy can also be affected. Luckily with up to date knowledge, the medical field is helping the majority to become parents!
The immune system is made up from interacting biological structures and functions throughout the whole body. It's our protection against germs, illness, and disease!
The body recognizes the difference between our own bodily cells and invading foreign cells that can cause infection. Therefore we have numerous different defense mechanisms within us, to protect against or to destroy these harmful invaders.
When a pathogen (e.g. a virus or bacteria) enters the body, warning signals go off and the immune system responds. This involves communication between our cells allowing different biochemical processes to happen. We also have special memory immune cells, so the next time the same pathogen enters the body it's dealt with quickly and efficiently!
The immune system usually does a sufficient job, but unfortunately in some circumstances things may go not go according to plan! We'll discuss immune system disorders that may affect fertility (immune infertility) including overactive and underactive conditions. A general doctors check and routine diagnostic tests can tell a lot about a person, so this is the best way to assess your health and/or manage any existing medical conditions.
If necessary you'll be referred onto an specialist who deals with immune system disorders. Examples are a rheumatologist, hematologist, reproductive endocrinologist, reproductive immunologist, or a fertility clinic. Fertility preservation is a possibility for those with more severe cases of disease.
Fertility and the immune system
A healthy immune system is essential for the body to function normally including the reproductive system! Hormones and the immune system are closely related.
A struggling or defective immunity can make a person more susceptible to diseases that could affect their fertility in various ways. Besides those with evident health issues, experts have indicated that 20% of all unexplained infertility cases may be related to immune system disorders of some sort. This simply means that no other obvious medical explanation had been identified.
Women naturally have stronger immunity than men because of their reproductive role including protecting a fetus. Certain immune cells involved with inflammatory response (and their secretory products) are an essential part of the ovulation process. They're also involved with the preparation of the endometrium (lining of the uterus) for the implantation of a fertilized egg.
The healthier you are the better because compromised health equals compromised fertility!
So if you're considering trying for a baby in the near future think about how you can be at your very best, to help improve your chances of conception and a healthy pregnancy. Even a short bout of sickness/fever (e.g. flu) can temporarily affect sperm count or contribute towards ovulation irregularities.
Many cases of long term unexplained infertility have been resolved when a person has taken up a much cleaner lifestyle therefore strengthening their immunity. This includes a nutritious organic diet, drinking enough water, stress reduction, regular exercise, adequate sleep, and reducing chemical exposure and toxins.
Excessive alcohol, smoking cigarettes, or taking recreational drugs all dramatically take their toll on the immune system and fertility health may consequently suffer. If you have a known medical condition, then these changes will also be a positive step as a strengthened immunity can help lessen any ill effects.
Now is the best time to make some changes, before you start trying to conceive! A
plan (three – six months) is recommended to give the body enough time to detox and improve health wise. This will also ensure the best possible start for a growing new life!
Autoimmune disease and fertility
An autoimmune disease is when the immune system malfunctions and mistakenly turns on itself triggering inflammatory responses, and destroying healthy cells/tissue. There are over 80 known types of autoimmune diseases. You may have heard of some of the most common types such as - lupus, type 1 diabetes, Crohn's disease, Graves' disease, multiple sclerosis, or rheumatoid arthritis.
It's not exactly known why these immune system disorders happen, but they seem to run in families (genetic predisposition) and may involve environmental factors or previous infection. Immune reactions may be localized or involve whole bodily systems, and tend to run in cycles of flare and remission. Members of one family often have different autoimmune diseases from each other.
This is far more common in women (approximately 75% of cases) and is often diagnosed during childbearing years. There may be several reasons why females are effected more than males including the fact that they have stronger inflammatory responses. This usually works for their benefit, however this process can become hyperactive easier than with men therefore triggering an autoimmune disease. Women's sex hormones are thought to play a role as many of these conditions seem to flare and calm down along with hormonal fluctuations e.g. menstrual cycle, or pregnancy.
Symptoms differ for each individual, and likewise so do the medical treatments. A lot depends on which autoimmune disease a person has and the severity of symptoms. Numerous medications are used to treat these types of conditions depending on the diagnosis including - immunosuppression drugs, non-steroidal anti-inflammatory drugs (NSAID's) corticosteroids, or hormone therapy. Occasionally surgery may be necessary.
Some autoimmune diseases can contribute towards fertility problems and/or conception difficulties (both sexes) or pregnancy loss, although others pose little problem. Certain prescribed medications for these immune system disorders can also effect fertility in varying degrees for either men or women - some more substantially than others.
If you have an autoimmune disease and are wanting to conceive please discuss your condition with your personal physician, Ob/Gyn, urologist, or specialist well in advance. Your doctor can help you plan and prepare, giving you the best possible advise for a successful outcome. This will involve assessing your medications, recognizing specific triggers, improving any particular lifestyle and dietary issues. Timing may factor - to be in remission if possible.
Women - caution must be taken regarding certain medications taken for autoimmune diseases as some can have an adverse effect on a growing fetus. However there are options which will be discussed with you. Your doctor/specialist will advise you if your current prescription is safe during pregnancy, or if changing/reducing doses, or stopping the medication temporarily is an option. Regular supervision throughout the pregnancy is important.
Please remember don't ever stop taking prescription medicines without consulting your doctor first!
If you've just recently been diagnosed with one of these immune system disorders make sure you ask questions! Find out from your physician how this might relate to your reproductive system and fertility in the future years ahead. Things may be a little more complicated as there are more factors to consider preconception and during pregnancy, but many people with autoimmune diseases go on to have normal healthy babies.
Antiphospholipid syndrome (APS) and pregnancy
APS is common in conjunction with other autoimmune diseases, but may also occur on its own. Occasionally a class of immune cells (antiphospholipid antibodies) interfere with the normal functioning of blood vessels causing coagulation (blood clots). This syndrome can also cause pregnancy related complications such as recurrent miscarriage, placental infarction (tissue death) preeclampsia (hypertension in pregnancy) premature birth, or stillbirth. Some experts believe it may also be responsible for infertility by way of implantation failure. The production of antibodies against a cell membrane substance (phospholipid) is the cause.
A physician may order tests to determine if this autoimmune factor is present, depending on clinical findings. Prescribed medical treatment usually involves low dose aspirin and/or a blood thinner called Heparin. Preventative measures can then be taken for future pregnancies.
Ether men or women can produce antisperm antibodies. Normally antibodies are made in response to foreign substances entering the body, but in this case they're accidentally produced against sperm! Antibodies then attach to sperm cells hindering their movement and make it difficult for them to pass through cervical mucus. Sperm cells can become clumped together, and/or they can be destroyed.
Men may develop these because of any disruption between the normal blood testes barrier such as a vasectomy reversal, testicular torsion (twisting of the testicle) injury, or infection. There may also be no known reason why a man has developed antisperm antibodies. Less commonly women may produce antisperm antibodies in their cervical mucus but the reasons for this happening aren't fully understood.
Antisperm antibodies may be responsible for otherwise cases of unexplained infertility. Tests can easily be conducted to see if this immune system disorder may be a cause. Medications that suppress the immune system may be prescribed such as a course of corticosteroids (e.g. Prednisone) and/or assisted reproductive technologies may help. The various ARTs have been found to offer the best results, although these come with a monetary cost.
Women's allergy to semen
This is one of the rarer immune system disorders, when a women may be truly allergic to her partners semen (fluid which carries the sperm cells). Some females can even go into shock and this may become a life threatening situation. Condoms are usually used, but when the couple wish to conceive then artificial insemination can help. Sperm cells are separated from the seminal fluid and placed in the females reproductive tract.
Recurrent miscarriages or failed IVF
Recurrent miscarriages may be caused by an immune dysfunction. This happens when immune cells attack a fetus or interfere with its growth. Several conditions have been identified involving different types of leukocytes (white blood cells) and/or antibody irregularities. We'll talk about one disorder...
Blocking antibodies - biochemical messages from a growing fetus send signals to the mothers immune system. Some of these signals come from the fathers contributed genetic material known as human leukocyte antigens (HLA). When a women becomes pregnant her immune system recognizes the fathers half of the HLA as being different from her own. Fetal blocking antibodies are then produced within the uterus to coat and protect the fetus from the mothers own immune cells, which otherwise would defend against any foreign invaders.
If the fathers HLA is too similar to the mothers her cells may not pick up on the difference, which is essential for the production of blocking antibodies.
In cases of recurrent miscarriage or failed IVF a reproductive immunologist can evaluate laboratory tests for any immune system disorders that may be contributing factors. Your obstetrician will test for most other causes. There may be a combination of reasons. With today's newest immunological discoveries there are a range of treatments available with very good success rates.
The term immunodeficiency is used to describe a deficiency or absence of one or more of the immune systems components. This may be hereditary, the result of a genetic disease, acquired through infection, a complication from illness, malnutrition, age, or through certain medications. Most cases are secondary, but occasionally a person is born with defects of their immune system (primary).
Immunodeficiency symptoms range from mild with only occasional bouts of illness, to severe and life threatening. Commonly the specialized immune cells called T and/or B lymphocytes don't work properly, or the body doesn't produce sufficient antibodies to fight off antigens.
Reduced immune system performance leaves a person vulnerable to opportunistic infections - pathogens that don't cause disease in a healthy host. This is in addition to normal infections that anyone can get. If you're suffering from repeated infections, symptoms that aren't entirely clearing, slow healing, or unusually severe infections, don't hesitate to see your doctor! Preventing infection is the first aim, although there are numerous medical treatments to help keep immunodeficiency under control.
With known cases of immunodeficiency careful consideration and planning must be undertaken by both patient and physician with regards to fertility health and conception (as each case is very different).
Related article -
What is the immune system made of? Learn about the different biological processes that make up the immune system - for anyone out there that may be interested!
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