Immunological Infertility

Definition - What does Immunological Infertility mean?

Immunologic infertility refers to infertility or miscarriage caused by immune attacks on reproductive tissues. The immune system may attack one's own sperm, egg, or uterine wall cells; or a woman's body may attack sperm or fetal cells. The end result is repeated failure to conceive or carry to term.

FertilitySmarts explains Immunological Infertility

There are two major types of immunologic infertility:

  1. Autoimmune infertility is when a person's immune system attacks their own reproductive cells.
  2. Alloimmune infertility is when the immune system attacks cells belonging to someone else such as sperm cells or fetal cells, resulting in miscarriage or difficulty conceiving.

In autoimmune infertility in men, a man's immune system attacks his own sperm, leading to lack of sperm production, or to unhealthy sperm that may not be able to successfully fertilize an egg. It is thought that vasectomy surgery may increase the risk of autoimmune infertility in men.

In autoimmune infertility in women, egg cells or uterine tissues may be attacked by the immune system. If egg cells are attacked, they may become damaged and unable to produce a healthy pregnancy. If uterine cells are attacked, fertilization of the egg may occur - but the uterine lining may be unable to form a connection with the fertilized egg, resulting in a failure of implantation.

In extreme cases of alloimmune infertility, a woman may experience an "allergy" to sperm, with vaginal discomfort or even anaphylactic shock after unprotected sex. In the vast majority of cases, however, the only symptom of alloimmune infertility is repeated failure to conceive or carry to term.

Immunological infertility is frequently suspected in cases of repeated failure of in vitro fertilization, where it is known that viable fertilized eggs were introduced into the uterus but failed to result in pregnancy.

In these and other cases where immunological infertility is suspected, tests for unusual immune activity may be ordered. These tests include reproductive immunophenotypes, which look for any abnormalities in immune cell number or function, and immunobead binding tests, which test for the presence of anti-sperm antibodies.

Doctors may order medications such as prednisone to temporarily suppress a woman's immune system in cases where immunologic infertility is known or suspected. Treatment with anticoagulants may also be recommended, as the same mechanism which prevent clotting can prevent the binding of immune system antibodies to reproductive cells.

Some controversy exists as to the commonality of immunologic infertility and its subtypes. Some fertility doctors believe that immunologic infertility is quite rare, and rarely test or treat for it. Others believe that immune response plays a role in a large percentage of cases of unexplained infertility.

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