Diagnosing Immunological Infertility
Your doctor may suggest a few tests to find out if your immune system is playing a role in your fertility struggles. These tests look for antibodies, immune cell activity, or genetic factors that might be causing problems. This is what you might expect:- Immunophenotype from blood: This test measures the number and proportion of lymphocytes in your blood to see if your immune system is overactive or imbalanced.
- Congenital hypercoagulability gene test: This test looks for genetic traits that make you more likely to develop hereditary thrombophilias.
- APA testing (antiphospholipid antibody testing): Looks for autoimmune markers like lupus anticoagulant and anticardiolipin antibodies that are linked to clotting and pregnancy loss. Applicable to both men and women.
- Allo MLR: This checks for antibodies that treat the embryo as a foreign object. If present, they can prevent implantation or cause early miscarriage.
- Microcytotoxicity test: This examines a woman’s blood for antibodies that attack her partner’s lymphocytes.
- Antibodies analysis: This test detects antiphospholipid syndrome by looking for antibodies like lupus anticoagulant or anticardiolipin, which cause clotting issues and pregnancy loss.
- HLA-C test: This checks for HLA-C antigens to determine if the immune system sees the embryo as a threat.
- ANA 1, 2, 3: This test looks for antibodies that indicate autoimmune disorders, which can contribute to infertility.
- Homocysteine test: This measures levels of homocysteine. High levels can signal thrombotic diseases that affect fertility.
- Inhibin B test: A hormone test that measures the level of inhibin B, which reflects ovarian reserve in females and sperm production in males.
- Karyotype test: This genetic test examines the size, structure, and number of chromosomes to identify abnormalities that might affect the immune system and fertility.
- Immunological study with endometrial biopsy: This advanced test is done during the luteal phase of your menstrual cycle. It involves a blood test and an endometrial biopsy to assess the activity and number of natural killer (NK) cells and T lymphocyte subpopulations in the endometrium. It helps identify immune imbalances that could prevent implantation or cause miscarriage. However, their benefit are still under research. The evidence is mixed, and treatment is usually individualised and off-label.
These tests aren’t typically part of routine fertility checks, so you may need to specifically request an immunological study if you’ve had multiple failed IVF attempts or recurrent miscarriages.
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Treatment Options for Immunological Infertility
The treatment involves calming the immune system, improving blood flow, or bypassing immune barriers to help you conceive and maintain a pregnancy. These are the main treatment options:- Intrauterine insemination (IUI): IUI might be suggested if antisperm antibodies are present. It helps by placing sperm directly into the uterus so they don’t have to pass through cervical mucus, where the antibodies are usually present. This reduces the chance of the immune system attacking the sperm before it reaches the egg.
- In vitro fertilisation (IVF): IVF is often recommended for cases where antisperm antibodies are widespread in a woman’s reproductive system. In IVF, a sperm is injected directly into an egg in a lab, bypassing any interaction with antibodies. This can increase the chances of successful fertilisation.
- Immunomodulators: These medications, like steroids, help reduce an overactive immune response. They make it easier for an embryo to implant and develop without being attacked.
- Anticoagulants and antiplatelet agents: For conditions like antiphospholipid syndrome or hereditary thrombophilias, blood-thinning medication is used to prevent blood clots that could harm the placenta or foetus. These are especially helpful for women with a history of miscarriage due to clotting issues.
- Intralipid or IVIG therapy: These therapies help balance the immune system by reducing harmful immune responses, particularly in cases of NK cell overactivity or alloimmune implantation dysfunction. They can improve the chances of successful implantation and pregnancy.
- Lifestyle and stress management: Even though it’s not a direct treatment for immune issues, managing stress and maintaining a healthy lifestyle can support hormonal balance and overall immune health.
Dealing with immunological infertility can feel overwhelming, but many couples go on to have healthy pregnancies with the right diagnosis and treatment. It's important to work with a specialist who understands immunological issues and can guide you through the testing and treatment process. If you’ve been facing unexplained infertility, multiple failed IVF cycles, or recurrent miscarriages, don’t hesitate to ask your doctor about immunological testing.
FAQs on When Your Body Mistakenly Fights Pregnancy: What You Should Know
- How do I know if my infertility is immune-related?
You might suspect it if you’ve had multiple failed IVF attempts, recurrent miscarriages or unexplained infertility. Specialised tests can check for immune reactions or genetic issues linked to fertility problems. - What tests are used to diagnose immunological infertility?
Tests may include blood tests, genetic screening, and an endometrial biopsy. These look for things like antibodies, immune cell activity and gene mutations that may affect fertility.
