“In the 1980s, it became clear to me that products of an activated immune system could damage the placenta and cause miscarriage, as well damage the embryo and cause implantation failure. Natural killer cells, which help to keep the body from developing cancer, can over-populate the uterus or exist at too high levels within the blood stream. These cells than go overboard, killing the embryo or interfering with the endocrine system that produces the hormones that are essential for pregnancy. This response can often be associated with complications for both the mother and her baby if the pregnancy occurs without treatment to suppress the activity of the immune system“. – Dr. Alan E. Beer (“Is Your Body Baby Friendly?”)
Dr. Alan E. Beer is widely considered as the pioneer in the field of reproductive immunology, he believes that it is not simply due to back luck that some women fail to conceive or have repeated pregnancy failure.
If you have a complex medical and fertility history, and failed fertility treatments, you might want to consider making further tests in advice with your doctor for your immune system. If you have repeated miscarriages, some doctors think that your immune system may be rejecting your pregnancy. So in normal pregnancy, it is thought that your body does something to stop the fetus being rejected. However, there is no convincing evidence that immune rejections of the fetus does actually ever happen in women with fertility problems.
summary of the most relevant testing:
- Antiphospholipid Antibodies (APA). These are the glue molecules for implantation and placentation.
- Antinuclear Antibodies (ANA). Some women develop antibodies to the baby’s DNA or DNA breakdown products and this problem is reflected by a positive Anti-nuclear antibody test (ANA). This is often with a speckled pattern. We also advise that women have testing to double-stranded DNA, single-stranded DNA, polynucleotides and histones.
- Elevated CD 56+ Natural Killer Cells. This test determines the killing power of a woman’s Natural Killer Cells in the test tube. Elevated NK numbers and/or NK activity can be associated with increased risk for infertility and loss.
- Th1/Th2 Cytokines (chemical messengers in the blood). The immune system is balanced between a TH1 (autoimmune) and TH2 (pregnancy or suppressive response). TH1 predominance can also be associated with reproductive failure. The Th1 Th2 Assay can help to determine a patient’s risk for this problem.
- T regulatory cells (Treg). Higher numbers of Tregs in the blood have been associated with better pregnancy outcome.
- Thrombophilias . Thrombophilia is increased tendency to clot.Throughout an entire normal pregnancy, the mother’s ability to produce blood clots in the uterus and the placenta is suppressed. However, in some mothers, this clotting tendency is not suppressed sufficiently. This can contribute to many pregnancy complications.
- CD57 cells in the endometrium. High levels of CD57+ cells may be associated with increased risk of infertility and loss.
From your circumstances, and medical history, your consultants aim to advice you on the most appropriate tests and treatments for you. Depending on the tests results you will get appropriate immune treatments and medications.
What should I ask my doctor?
If you are recommended immunological treatments as part of your fertility treatment, we advise you to make sure you feel properly informed about the potential benefits and risks of the tests and treatment.
Your clinic should explain:
- why they think the tests and treatment may help you
- what the risks and side effects may be
- the costs you will incur.