Automimmune Disease

It is well accepted by now that abnormal (auto)immune function may cause repeated pregnancy loss. Whether abnormal female immune functions can also cause infertility remains, however, controversial. Based on research performed at CHR, primarily by Norbert Gleicher, MD, and based on other published studies, we, at CHR, have come to believe in the concept of immunological infertility and offer, various, at times experimental, treatment options.

Because abnormal immune function can affect fertility as well as miscarriage risk, affected women need two layers of treatment: a first, to conceive, and a second, to prevent pregnancy loss after conception. This is a very important point because it would not make sense to help them get pregnant - only to see them experience a potentially preventable pregnancy loss.

If you wish to determine your options, we currently offer a Free Automimmune Disease and Infertility E-Mail Consultation.

What is an autoimmune disease?
The term autoimmune disease refers to a varied group of more than 80 serious, chronic illnesses that involve almost every human organ system. In all of these diseases, the bodys immune system becomes misdirected, attacking the very organs it was designed to protect. About 75% of autoimmune diseases occur in women, most frequently during the childbearing years. Autoimmune diseases can affect connective tissue. (This is the tissue which binds together various tissues and organs.) It can also affect the nerves, muscles, endocrine system, and gastrointestinal system.

What are common examples of autoimmune diseases
Multiple sclerosis (MD Link), myasthenia gravis, (MD Link), autoimmune neuropathies, (MD Link), Guillain-Barre (MD Link), and autoimmune ureitis (MD Link), affects the nervous system.

Crohn's disease (MD Link), ulcerative colitis (MD Link), primary biliary cirrhosis (MD Link), autoimmune hepatitis (MD Link) affects the gastrointestinal tract.

Autoimmune hemolytic anemia (MD Link), pernicious anemia (MD Link), autoimmune thrombocytopenia (MD Link) are hematological (blood-related) autoimmune conditions.

Type 1/immune mediated diabetes mellitus (MD Link), Grave's disease (MD Link), Hashimoto's thyroiditis (MD Link), autoimmune oophoritis/orchitis (MD Link), autoimmune adrenal diseases (MD Link) affects the endocrine glands

Temporal artertis (MD Link), anti-phospholipid antibody syndrome (MD Link), vasculitides (MD Link), Wegener's granulomatosis (MD Link), Behcet's disease (MD Link) affects blood vessels.

Psoriasis (MD Link), dermatitis herpetiformis (MD Link), pemphigus vulgaris (MD Link), vitiligo (MD Link) are autoimmune diseases of the skin.

Rheumatoid arthritis (MD Link), systemic lupus erythematosus (MD Link), polymyositis (MD Link), dermatomyositis scleroderma (MD Link), spondyloarthropathies (MD Link), Sjogren's syndrome (MD Link), also often called connective tissue diseases, can affect multiple organs.

What causes autoimmune diseases?
Unfortunately, autoimmune diseases remain among the most poorly understood illnesses. It is thought that hormones play a role in inducing autoimmune diseases; some cases suddenly improve during pregnancy, others flare-up during, or after pregnancy. Yet, others may flare up only after menopause.

Autoimmune diseases also show a strong hereditary component, but mysteriously, can cluster in families as different consitions. For example, a mother may have lupus erythematosus; her daughter, scleroderma and her grandmother, rheumatoid arthritis. Ongoing research is attempting to shed more light on genetic, hormonal and environmental risk factors that contribute to the occurences of autoimmune diseases.

How are autoimmune diseases diagnosed?
The diagnosis of an autoimmune disease is based on symptoms, findings from a physical examination, and results from laboratory tests. Specific autoimmune diseases are, at times, difficult to diagnose, especially in the early stages of the disease, when symptoms and laboratory data may not yet be specific enough. Although autoimmune diseases are usually chronic, the course they take is often unpredictable.

How are autoimmune diseases treated?
Since autoimmune diseases are often chronic, they may require lifelong care and monitoring, even when the person may look and feel well. Currently, few autoimmune diseases can be cured or mad to disappear with treatment. However, many people with these diseases live relatively normal lives when they receive proper medical care.

How are autoimmune diseases treated for infertility?

As the causes of autoimmune diseases are not well understood, it is not surprising that we still lack specific treatments for the various conditions. What we can treat are usually selected symptoms of diseases, which, at times, may include infertility. Indeed, mostly through Dr. Gleichers work, we, in some women, have come to see infertility as a, fairly typical, early symptom of abnormal female autoimmune function.

Because of our special expertise in this area, CHR sees a large volume of women with clinically overt (but also sub clinical, early) autoimmune diseases who either suffer from infertility and/or pregnancy losses. The good news is that, with aggressive treatment, most patients can conceive and deliver healthy children.

In a preliminary, though quite provocative, study, published in 2006 in the Journal of Autoimmunity Dr. Gleicher for the first time suggested that the risk to develop autoimmune disease may be influenced by the way children are being delivered: Cesarea section delivery may reduce the risk to offspring, while at the same time increasing the maternal risk to flare her condition.

For more information on Dr. Gleicher's research see Scientific Publications. Click here for more information regarding our Autoimmune Disease Press Release Contact us if you would like our preliminary opinion on your Next Steps.