Immune Balance and Fertility

Immune balance and fertility are inseparable, and our understanding is growing each year. Most women have a relatively balanced immune system that can adapt to pregnancy. However, many of us have hidden immune problems that make conception and maintaining pregnancy more difficult. Testing is costly, difficult to access, or not considered a priority in all fertility clinics.

Imbalances in the immune system cause fertility problems for many couples and are involved in many cases of “unexplained infertility” because pregnancy requires a woman’s immune system to recognise and support the essentially “foreign” cells of her baby.

Because half the baby’s genetic material comes from the father, they’re not 100% the mother’s cells, and proteins on the cell walls show this. The woman’s immune system needs to recognise these abnormal cells and make changes to the womb and blood supply that encourage the embryo’s growth and prevent its removal.

Most couples with infertility don’t test for immune status as other more obvious and pressing conditions should be considered first. But it becomes more relevant when the usual causes of infertility (blocked tubes, hormonal problems, male factor, etc.) have been excluded. Immune conditions are more likely when couples have unexplained infertility, repeated miscarriages or IVF failures; however, older couples should bear in mind that miscarriage rates naturally rise with age.

Infertility and Miscarriage

For women experiencing infertility or a miscarriage in their late 30s, the cause is usually:

1. Chromosomal abnormalities (40-50%)
2. Blood-clotting disorders (20-25%)
3. Other reasons (25-40%)

Chromosomes have randomness to them that’s unlikely to repeat, but “blood-clotting” and “other causes” are often immune-related because either:

• The mother’s immune system recognises the embryo cells as “non-self” and attacks them in the same way it removes viral or bacterial invaders
• Clotting factors are often immune-based, and they disrupt the blood supply to the developing embryo

Immune system imbalances are core issues for many couples who can’t conceive naturally, who experience repeated IVF cycle failure or miscarriage, and for these couples, the problem is often:

• The woman’s immune system attacks eggs in the ovary, the embryo in the fallopian tubes, or at the implantation site
• For couples who have repeated miscarriages, an imbalanced immune system in one or both partners is the usual cause
• Repeated miscarriage affects less than 1% of couples but 2-5% of all pregnancies

It’s estimated that:

• 60% of women who have four or more unsuccessful IVF cycles have an immune-related issue
• 30% of couples who haven’t conceived naturally after trying for three years have an immune-related issue

Immune causes of infertility

A review of immune factors and reproduction in 2012 ⁱ concluded that “Substantial evidence suggests that:

• antiphospholipid antibodies 
• lupus anticoagulant
• anti-sperm antibodies
• anti-thyroid antibodies
• anti-endometrial antibodies
• anti-ovarian antibodies
• anti-C trachomatis antibodies
• cytokines 
• immunological events in endometriosis and premature ovarian failure” 

“…contribute to reproductive failure including unexplained infertility and/or non-chromosomal recurrent miscarriage.”

Without appropriate testing, couples with immune-related infertility are routinely diagnosed with “unexplained infertility”. The immune system is complex, and our digestion receives most of our immune challenges (and 75% of our immune cells). Bizarrely, certain types of roundworms in the gut increase fertility by reducing the immune response to other non-self cells (like an embryo). The immune system is also crucial for:

• The integrity of DNA in eggs and sperm
• The function of the ovaries (in both phases)
• The receptiveness of the endometrium for implantation (70% of IVF failures)

What’s increasingly clear is that the immune system plays a constant and vital role in both creating and maintaining life, and experts say:

“Women with implantation failures or recurrent miscarriage are unbalanced. They are too Th1 activated with cells that attack their pregnancy.”

Alan E Beer MD

Balancing the immune system

There are ways to balance the immune system with changes to diet and lifestyle, supplements and medicinal herbs. These are part of the morefertile^® memberships that give personalised advice and provide cutting-edge testing and quality products.