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Although controversial with some reproductive endocrinologists,
there is a growing interest by patients to consider problems with
the immune system as a cause for infertility or miscarriages,
especially if no other cause has been found. There is no consensus
among reproductive endocrinologists and reproductive immunologist,
and in fact the debate has been contentious. An informative article
in the journal Human Reproduction titled The immunological `Wars of the Roses':
disagreements amongst reproductive immunologists does a
good job of explaining the controversy, and I strongly recommend
that you read this if you are considering testing for
reproductive immunological problems.
Where to start for
information on Immunological Connections to Infertility and
Miscarriage:
- Check out the following Creating a Family radio shows:
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Symptoms for
Immune Related Infertility:
The following symptoms might lead
you to consider testing for immune related infertility (this
information was taken from the Aug. 20, 2008 Creating a Family show
on this condition). Keep in mind that they are fairly general in
nature and could be unrelated to the immune system.
General Health Problems:
Fertility and Reproductive Problems:
-
Unexplained infertility
-
Producing less than 6 eggs with a stimulated IVF
cycle
-
One blighted ovum
-
Three unexplained miscarriages or IVF failures
before age 35
-
Two unexplained miscarriages or IVF failures
after age 35
-
Endometriosis or any kind of pelvic
inflammation
-
One living child and repeat miscarriages while
attempting to have a second child
Previous Pregnancy Problems:
-
Unexplained uterine bleeding, especially in the
first trimester
-
cervical incompetence
-
preterm labor
-
premature rupture of the amniotic sac
-
preeclampsia
-
retarded fetal growth/small for gestational
age
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Books, Articles, and
Other Information Related to the Immunological Connection to
Infertility:
The problem couples face is finding reliable
information. Not all unexplained infertility or
miscarriages are related to the immune
system, and testing is not inexpensive and treatment may
require medication. And quite frankly, there is a lot of rubbish
out there, so proceed with caution. The following resources are a
good place to start.
-
Is Your Body Baby-Friendly: Unexplained Infertility,
Miscarriage & IVF Failure by Dr. Alan Beer, Julia
Kantecki and Jane Reed. This book gives a good overview of the
diagnosis and treatment of immune related infertility. The authors
spend time discussing the controversy surrounding this treatment,
without automatically dismissing it as unsubstantiated.
-
Shared Journey has a very informative page that
would be a good free starting place for your research.
-
"Immunology may be key to pregnancy loss" is an
article by Carolyn Coulam and Nancy Hemenway
-
Two articles by Dr. Geoffrey Sher that are a bit
technical, but may be of interest: IVIg for ART and Implantation Failure
Controversy and Embryo Interaction May Be Key to Diagnosis and
Treatment of Immunological Implantation Failure
-
The Alan E. Beer Center for Reproductive Immunology &
Genetics specializes in diagnosing and treating reproductive
problems caused by immune disorders.
-
Reproductive Immunology Societies I dont
know that these will be particularly helpful to the average
patient, but if you are looking for a doctor that specializes in
reproductive immunology, they should be a member of one of these
societies. Also, you can find some peer reviewed studies listed on
these websites and in their journals. American Society for
Reproductive Immunology, International
Society for Immunology of Reproduction (ISIR), EMBryo Implantation Control (EMBIC), a European Network of
Excellence.
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Support
Groups:
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