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What Is Reproductive Immunology And How Can It Help Me Get Pregnant?

If you have experienced repeated miscarriage or IVF failure, you may be completely at a loss. Reproductive immunology may be the answer you’ve been looking for. Deciding to go ahead with assisted conception or to try for a baby one more time after repeated heartache takes enormous courage. And then to be told it’s simply ‘bad luck’ can be still more distressing.

While there is still much debate about it among clinicians and more large scale trials to be conducted, some elite reproductive doctors believe that couples that have experienced repeated IVF failure or recurrent miscarriage may be helped by reproductive immunology.

Dr Amin Gorgy

One of London’s top IVF centres The Fertility and Gynaecology Academy specialises in complex cases, and reproductive immunology. So we spoke with their renowned co-founder, Dr Gorgy, to find out more.

What is Reproductive Immunology?

Reproductive immunology involves studying the action of the immune system in pregnancy. It is the theory that in some women, the foetus is rejected because of the activity of the body’s immune cells.

“It is believed that natural killer (NK) cells whose function it is to stop the body developing cancer, can over-populate the womb or exist at excessively high levels in the blood. These cells then go into overdrive, attacking the embryo or compromising the endocrine system which generates a woman’s essential pregnancy hormones,” Dr Gorgy told us. “So after ensuring you have been screened to eliminate any straightforward roadblocks to successful pregnancy, we run blood tests to investigate the immune system.”

What Is Reproductive Immunology And How Can It Help Me Get Pregnant?

We can help you find a Private Fertility Clinic / Hospital, or a Private Fertility Consultant who specialises in reproductive immunology treatment.

What Does Reproductive Immunology Treatment Involve?

If the test results indicate them, immune therapy treatments can be tailored specifically to a woman’s individual immune profile. Treatments include:

  • Humira – TNF-alpha is a type of messenger protein produced by white blood cells. It helps to regulate the immune system’s reaction to foreign objects, promotes inflammation and can help cell healing. But unusually high TNF-alpha levels have been associated with miscarriage, implantation failure and lower egg quality. Humira injections are very effective in bringing down elevated TNF-alpha levels. It can also help some women with high uterine NK cells and/or endometriosis.
  • Infusions of Intralipid and/or IVIg (Intravenous immunoglobin) – IVIg is a mixture of human antibodies, and Intralipid is a mixture of glycine, egg yolk and soya bean oil diluted in saline. Both IVIg and Intralipid have been demonstrated to regularise the killing action of the blood’s NK cells.
  • Corticosteroids – Corticosteroid tablets can be used to curb natural killer cells and inflammation.
  • Clexane – Thrombophilia (‘sticky blood’ disorders) can restrict the flow of blood to your placenta or uterine lining, inducing pregnancy failure. Higher levels of NK cells have also been linked to similar blood flow problems. Clexane is a blood thinning medication.
  • Lymphocyte Immune Therapy (LIT) – The Leukocyte Antibody Detection (LAD) screening ascertains the levels of the antibodies that respond to proteins of non-self (usually paternal). These are crucial antibodies because they appear to help protect pregnancy. Women who have experienced repeated miscarriage may show especially low LAD levels. In these instances, LIT has been demonstrated to increase live birth rate by elevating a woman’s blocking antibody levels. LIT involves injections of white blood cells from a healthy blood donor (most often the prospective father).
  • Progesterone – Women with immune disorders may be helped by greater than average progesterone doses, to counteract anti-progesterone antibodies or inflammation.
  • G-CSF (Neupogen) – G-CSF can stimulate white blood cell production. It has been found to aid embryo implantation and lower miscarriage risk, especially in women who are deficient in killer cell immunoglobulin-like receptors (KIR). CSF has also been associated with improved uterine lining.
  • Antibiotic treatment – Dependent on the results of infection testing or the medical history of either yourself or the prospective father, various antibiotics may be prescribed.
  • Metformin – Metformin reduces insulin resistance, and therefore women with polycystic ovarian syndrome or other insulin resistance problems can be helped by daily doses of it.
  • Folic Acid, Vitamin B6 & B12 – MTHFR gene mutations can hinder your body’s ability to expel toxins and to properly use folic acid and vitamin Bs. So while all women trying to get pregnant are advised to take folic acid and vitamins B6 and B12, if tests have identified MTHFR gene mutations, you may be prescribed elevated doses of folic acid and vitamins B6 and B12.

Dr Gorgy told us: “There are no guarantees. But for women with repeated failure or recurrent miscarriage, we don’t believe in simply pulling them through another round of IVF without further investigations. And we have seen many such couples give birth to healthy babies after immune treatments.”

Related article: Treating Recurrent IVF Failure & Recurrent Miscarriage 

 

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