Now accepting Telehealth appointments. Schedule a virtual visit.

Signs of Immunological Infertility

What are the signs of immunological infertility and immune-related pregnancy loss?

Diagnostic challenges of immune-related infertility

Please note that the question addressed here is _not _when to suspect an autoimmune problem or when to suspect any other immune system-related problems. This is on purpose because we, again and again, want to stress the point that it is not autoimmunity (or any other single factor) that, likely, causes implantation failure and miscarriages but inadequate development of tolerance, which subsequently is responsible for an allo-immune (not auto-immune) attack on the pregnancy.

Let us, therefore, answer the here posed question, which is actually a very difficult one to answer for most patients. There are many reasons for that: Since our understanding of how a woman’s immune system develops the necessary tolerance toward an implanting embryo and the growing pregnancy is at best incomplete, one currently still must accept that we can never be absolutely certain in diagnosing an immune problem as it relates to pregnancy. Specific tests to reach a diagnosis of immunological infertility do not yet exist, whether infertility is due to premature ovarian aging (POA), also called occult primary ovarian insufficiency (oPOI), an implantation problem, or repeat miscarriages. We know that all of these conditions (and some additional ones, like the recently reported hypo-androgenic-like PCOS), are all statistically associated with autoimmunity and, therefore, with a hyperactive immune system.

When to suspect immunological infertility

So, when then should one suspect that a female infertility patient may have a hyperactive immune system? The table summarizes the answers and demonstrates that a hyperactive female immune system should be suspected with patient or family history of autoimmunity, inflammation and/or hyper-allergenic responses and with specific patient diagnoses, such as unexplained infertility, POA/oPOI, POF/POI or H-PCOS-like phenotype. Though autoimmunity is, likely, the by far most frequent cause for a hyper-active immune system, it is not the only cause of immune system hyperactivity.


Signs of female hyperactive immune system resulting in fertility issues

At CHR, physicians stay vigilant for these signs of hyperactive immune system that may be resulting in immunological infertility or immune-related pregnancy loss


This is why searching only for autoimmunity would be the wrong approach. It is the development of inadequate tolerance due to hyperactivity of the maternal immune system that is the cause of most immunological infertility because insufficient tolerance levels activate allogeneic immune responses against the pregnancy, at whatever stage it may be. And this is precisely why being on the lookout for signs of immune system hyperactivity is the first, crucial step in treating immunological infertility.

Norbert Gleicher, MD

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

Follow on LinkedIn    

Watch his videos on YouTube    

 


We have helped women bring over
17,800 babies into the world.

DISCOVER YOUR TREATMENT OPTIONS

 

You Might Also Enjoy...

IVF after 40 years old

Trying To Get Pregnant After 40 Years Old

For women trying to get pregnant after 40, CHR believes in an urgent and individualized treatment approach. Time is a very important factor with DOR, and the sooner treatment can be started, the higher a woman's pregnancy chances.
Am I a Candidate for Egg Donation?

Am I a Candidate for Egg Donation?

Egg donation is a beneficial treatment that can assist women who can’t conceive with their eggs. Find out what goes into the egg donation process here.

The March/April Voice

Every issue of the VOICE slowly drifts towards more professional subjects, peaking with the literature review, which, primarily addresses physicians and scientists.
IVF in Alabama - What To Do Next?

IVF in Alabama - What To Do Next?

CHR offers the safe transfer of existing frozen embryos into our facility, ensuring continuity of care for patients affected by the suspension of IVF services in Alabama.