In vitro fertilization IVF has changed the landscape for couples struggling with infertility. It provides hope and the ability to start a family to many people who otherwise would not be able to conceive.

However, the success of IVF can sometimes be hindered by the complex interplay between the immune system and the reproductive process. Understanding this connection is crucial for people undergoing IVF.

It is important to understand that a balanced and strong immune system is essential for a successful pregnancy, but certain immune system disorders can create problems with conception and beyond.

The immune system plays a critical role in maintaining a person’s overall health. In particular, the adaptive (specific) immune system produces antibodies that are used to fight specific microbes that the body has previously come into contact with.

The importance of a balanced immune system in pregnancy is vital as it helps the uterus to accept and nourish the fetus. Immune cells residing in the reproductive tract play contradictory roles: they maintain immunity against vaginal pathogens in the lower tract and establish immune tolerance for sperm and embryos in the upper tract.

Disorders of the immune system (autoimmunity, alloimmunity, etc.), affect all stages of reproduction, even the outcome of an in vitro fertilization.

In autoimmune diseasesthe body’s immune system attacks healthy cells and tissues, considering them foreign or abnormal, producing antibodies against them. Autoimmune disorders can increase the risk of pregnancy complications and adverse outcomes such as miscarriage, preeclampsia, gestational diabetes, intrauterine growth restriction, preterm birth, and low birth weight babies.

Due to the critical role of the Immune System in the implantation of an embryo in the uterus and the development of a pregnancy, a disorder of the immune system can be one of the causes of Infertility. It is necessary to consider the possibility of certain autoimmune diseases – especially if there is an effort to conceive – for a long time (there is infertility), or repeated miscarriages.

Some Autoimmune Diseases that cause the above problems are:

  • Autoimmune Thyroid Diseases.
  • Reduced ovarian reserve, due to Autoimmunity.
  • Antiphospholipid antibody syndrome (APLAS).
  • Rheumatoid arthritis.
  • Systemic lupus erythematosus.
  • Anti-sperm antibodies, etc.

These conditions can also affect the ovaries, reducing the ovarian reserve or the number of eggs left in the ovaries. This can lead to early menopause and infertility. Immunological Implantation Dysfunction (IID) is a phenomenon that can drastically reduce the chance of successful implantation and pregnancy.

In the presence of autoimmunity, approximately half of in vitro pregnancies fail during the implantation stage and many natural pregnancies fail as well. Infertility or RPL is caused by immune implantation dysfunction (IID) in 15-20% of women. This can be caused by various conditions such as autoimmune disorders or chronic inflammation. In addition, certain genetic factors may also play a role in predisposing individuals to IID.

Therefore, it is important to evaluate and treat all women who have endometriosis (an autoimmune disease), unexplained infertility/recurrent IVF failure, RPL, or a personal or family history of primary autoimmune diseases.

Treatments for Immune Implantation Dysfunction (IID)

To address the issue of IID, there are several strategies to modulate the immune response during IVF.

A common approach is to use immunomodulatory drugs, such as corticosteroids or intravenous immunoglobulins (IVIG) and others. and especially the involvement of a Rheumatologist who deals with autoimmune diseases and Pregnancy. These drugs work by modifying the function of the immune system and reducing its activity, thus minimizing the risk of attacking the fetuses.

Lifestyle factors

In addition to medical interventions, improvement of lifestyle factors – can affect the immune response during IVF. A healthy diet, regular exercise, and stress management can all contribute to a well-functioning immune system. In addition, avoiding toxins and maintaining a healthy body weight can help improve the chances of successful IVF results. It is important to note that the relationship between the immune system and IVF is still being researched.

The immune system and the in vitro fertilization have a complex relationship that can affect the success of fertility treatments. Understanding this connection and implementing appropriate interventions can increase the chances of successful implantation and pregnancy. The patient-physician team communication as well as the cooperation of the Assisted Reproduction physicians with the Rheumatologist is the key to success.