What are Immunological Fertility Issues?
First, we must understand that the immune system is a complex network in the body. The immune system refers to all parts of the body that work to defend it against harmful enemies. In people with immunological fertility problems their body identifies part of reproductive function as an enemy and sends Natural Killer (NK) cells to attack. A healthy immune response would only identify an enemy correctly and attack only foreign invaders such as a virus, parasite, bacteria, etc. 

Immunological Fertility Testing
People with the following indications may want to consider getting testing by a Reproductive Immunologist. A Reproductive Immunologist differs from a Reproductive Endocrinologist, which most couples are referred to when fertility issues are not determined by an OBGYN, or other doctor. Reproductive Immunologists have the training and skills to determine if there is in fact an immunological response gone awry that is causing difficulty in getting pregnant or carrying to full term.

• 2 or more miscarriages after the age of 35
• 2 IVF failures after the age of 35
• 3 miscarriages before the age of 35
• 1 failed IVF before the age of 35
• Poor egg production from a stimulated cycle (6 eggs or less)
• Blighted ovum
• Pre-existing immune problems (Lupus, Rheumatoid Arthritis, MS)
• Unexplained Infertility diagnosis
• Previous pregnancies showing retarded fetal growth
• 1 healthy pregnancy with all subsequent pregnancies ending in miscarriage
• Endometriosis, especially stage 1 & 2
• Cold and flu-like symptoms, sore throat noted regularly after ovulation, IUI, or IVF transfer
• Family history of immune disorders, either side of the family

Immunological Causes of Recurrent Miscarriage

Problems with Embryo Signaling
Once conception has taken place, the developing embryo must signal the mother’s immune cells to recognize it as “self” rather than a foreign invader. The embryo does this by secreting HLA G antigen to signal the mother’s immune cells to allow it to grow and stay. In this case, HLA G antigen improperly functions and the mother’s immune cells attack the embryo, eventually resulting in miscarriage. This is considered an HLA G gene mutation. There is testing to determine if this is happening.

Problems with the Mother’s Immune Response to the Embryo
This is when the mother’s immune cells do not respond to the healthy signal of HLA G antigen release. Again, the mother’s immune cells attack the embryo. When an embryo is attacked it is not destroyed, but causes inactivation of the DNA in the embryo so that these cells stop dividing and replicating. The embryo fails to grow and dies. There are a series of blood tests that can be performed to determine which immune cells are malfunctioning.

Thrombophilia: Blood Clotting Issue
This happens after the mother’s body recognizes the baby as part of herself and the embryo has implanted. The vessels in the placenta take blood and nutrients to the fetus. In the case of a blood clotting issue-related immunological miscarriage, those vessels clot off, literally starving the embryo of oxygen, blood, and vital nutrients. Blood testing can determine if this is a factor.

Antisperm Antibody
In some people semen can cause an immune response in men or women. Antibodies are triggered during the immune response that “attack” sperm. High numbers of sperm antibodies can make it difficult for the sperm to reach the egg, and/or fertilize the egg. Antisperm antibodies may damage sperm that survive, which may increase the chance of miscarriage.

How Does This Happen in Men?
A man’s body may create antisperm antibodies when the sperm come into contact with his immune system’s “killer” cells. These cells are typically a good thing – they protect the body from foreign invaders, in order to keep us healthy. In the case of antisperm antibodies, they identify the semen and the sperm within as the “enemy”. When the testicles are injured, after surgery (biopsy, vasectomy), or if the prostate gland has an infection. The testicles protect the sperm from immune cells, when they are damaged they may no longer be able to do that.

How Does This Happen in Women?
This is very rare but, in some women their bodies have an allergic reaction to her partner’s sperm. This stimulates the immune system to create antisperm antibodies that attack her partner’s sperm. This may also cause her vaginal tissues to react to the semen, which may result in rash, sores, or painful sexual intercourse. Doctors are not sure why this happens.