The relationship between the immune system and fertility

Infertility affects a great number of couples. It is estimated that 40% of the cases are due to male infertility, while another 40% are due to female infertility; therefore, the cause of infertility is quite evenly distributed within the couple.

From the emergence of assisted reproduction techniques, many infertility issues have been solved, and nowadays it is possible to achieve a pregnancy and have healthy babies even in complicated cases by for example: using sperm cells obtained through testicular biopsy, selecting the genetically healthy embryos before the transfer through genetic diagnosis techniques, etc.

However, there are still gaps about how the pregnancy is established, the interactions needed for the embryonic implantation to take place,  the moment when the endometrium is most receptive and, in general, many aspects of the processes that take place in the mother’s body are still unclear.

In the last few years, fertility and reproductive medicine specialists have designed new tests to perform on couples with infertility issues.

These tests are aimed at studying the state of the future mother’s immune system, since it is known that alterations in immune cells or molecules can produce miscarriages, implantation failures, obstetric problems, etc…

Our body’s immune system includes a wide variety of cells, which main function is defending our body against foreign organisms. These cells have different characteristics and abilities depending on their location, thus allowing the immune system to effectively fight a great number of pathogens every day.

We can find immune cells in most of our tissues, they act as guardians of our health.

The study of the immune factor in assisted reproduction includes various elements such as: antibodies, lymphocytic subpopulations, NK cells, etc. NK cells for instance, can innately recognise cell defects, and they activate to destroy these defective cells.

In order for the immune system to work properly it is essential that it is capable to distinguish between ‘own’ (the components of our own body) and ‘foreign’ (possible disease-causing agents). When this recognition is faulty, illness follows (immunodeficiency, autoimmunity, allergy, etc…)

Based on these premises, anything that is foreign to the body can be recognised by a healthy immune system that would then activate and act to destroy the threat.

Pregnancy represents a special situation, from an immunological point of view.

The embryo happens to be ‘foreign’, since it contains genetic material from the father, and therefore unknown by the mother’s immune system.

It is supposed that a mechanism exists that generates tolerance in the mother towards the embryo, thus allowing the pregnancy to proceed normally. Nowadays it is unclear what this mechanism consists of and how we can activate it. What we do know is that patients with certain alterations in immune system components suffer miscarriages and implantation failures, even after undergoing different fertility treatments, including IVF.

However, in most cases it is possible to diagnose and treat these alterations, which considerably improves the reproductive prognosis, making it possible for most of these patients to achieve a pregnancy and give birth to a healthy baby.

A few years ago, a new medical specialisation emerged within immunology

Reproductive Immunology, which is responsible for the immunological studies aimed at the diagnosis and treatment of patients that have showed reproductive failures of a probable immune cause.

In the international fertility clinic IVF Spain, we have professionals specialised in Reproductive Immunology for the study and treatment of patients with infertility-causing immune alterations. Equipped with our high level of expertise and all the technical and technological resources currently available, we can apply the most innovative treatments and achieve excellent results in patients with immunological pathology.

As mentioned before, the immune system is formed by a series of organs and cells that make up our defence against infections.

For this system to work properly an essential requisite must be met: the immune system cells must be able to recognise the own body’s components and not attack them, and also recognise pathogens and potentially dangerous foreign agents and react to them adequately to ensure the foreign agent neutralisation and the body’s protection.

Pregnancy is an immunologically exceptional state in which an immune response can be triggered which can terminate it.

But this is not what happens, and this coexistence is allowed for 40 weeks. Pregnancy is therefore a process with an important implication of the immune system, and any alteration in the balance of this system can lead to fertility issues.

When we encounter a patient that does not achieve pregnancy, we perform two studies

These studies distinguish us and place us above other fertility centres. An endometrial immunology test, that would allow us to modulate the patient’s immune response if it threatens to interfere with the embryo; and an endometrial receptivity test, which allows us to transfer the embryo exactly when the patient’s uterine lining is most receptive.

Normally these tests are performed in patients with a history of miscarriages with no known cause that justify them (genetic, anatomical, etc.,) or with a history of implantation failure. They are also performed in patients with a history of immune alterations or diseases, like patients with autoimmune diseases, since they are at a higher risk of immune-related infertility.

In IVF Spain the treatments for these alterations are completely personalised and tailored to the needs of each case

To us each patient is unique, just like their story; so we always apply a personalised approach to each and every infertility issue that we treat, thus guaranteeing our patients a treatment that is totally adapted to their needs and with the highest possible chance of success.

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