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: - Check out the following Creating a Family radio show:
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
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 don’t 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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