Unexplained infertility and recurrent miscarriage is a great source of emotional pain and frustration for many couples that are trying to start a family. Not knowing the reasons for being unable to conceive or sustain a pregnancy just adds to the feelings of failure and disappointment. After much controversy, Biomedical Science has been revolutionised with the discovery that the immune system could be the cause of IVF failure, pregnancy loss and infertility.
The immune system is a powerful protector against disease. It consists of special cells that club together to ward off “foreign” detrimental cells and organisms known as antigens. In some cases, the body’s immune system can misinterpret good cells like embryonic cells and it can destroy them even before implantation has occurred.
Dr. Alan E Beer from the Center for Reproductive Immunology and Genetics was a great pioneer of this theory, devoting more than 25 years of his life researching reproductive immunology. In his book Is Your Body Baby Friendly he identifies the five categories of immune issues and their responses in reproduction and explains it in an uncomplicated way. Sadly he died in 2006, but has left a great legacy behind him and many clinics are now taking on board his philosophy and solutions to achieve full-term pregnancies.
The Five Categories of Immune Issues
A “Baby-Friendly” environment to host the foetus depends on many complex immunologic reactions that the body undergoes in order for it to become ready for pregnancy. The following immune disorders are believed to inhibit this natural process very often even before any kind of implantation has occurred, or in some cases causing miscarriage.
- Category 1 : Tissues Type Compatibility
- Category 2 : Blood-Clotting Defects
- Category 3 : Immunity to Pregnancy
- Category 4: Antibodies to Sperm
- Category 5: Part One – Natural Killer Cells
- Category 5: Part Two – Antibodies to Hormones and Neurotransmitters
Each of the five categories are identified by special tests or symptoms that are displayed and in response to these issues, patients then undergo the necessary treatments to depress the immune system temporarily to make the body more hospitable to pregnancy.
Immune Therapy and IVF Treatment
Therapies such as IVIG, low-dose heparin, LIT and corticosteroid therapy can all aid in the suppression of the immune system leading up to and during an IVF cycle. Blood-clotting defects are treated with aspirin and low-dose heparin injections, IVIG (Intravenous Immunoglobulin) is a drip of good antibodies, administered slowly approximately seven to 10 days before embryo transfer and it can be paired with steroids, depending on the severity of the case. LIT (Lymphocyte Immune Treatment), is a serum made up from a donor or the partner’s blood, it is then injected in a series of injections under the skin, this will help to stop rejecting the male’s DNA.
Although some of these treatments like IVIG and LIT have received some bad press in the past due to them being a blood derivative, Dr. Beer’s clinic boasts a success rate of more than 80% in more than three IVF or natural cycle attempts. Reproductive immunotherapy has quickly become a common treatment at most fertility clinics and for some Infertile couples, the dream of having a baby is becoming a reality.