Autoimmune diseases and infertility can result in difficulty conceiving. Having any autoimmune disease (lupus, rheumatoid arthritis or Type I diabetes) generally increases your risk for infertility. But there are also specific autoimmune diseases that one should be tested for if one has infertility.
What is an autoimmune disease?
An autoimmune disease occurs when your immune system perceives your tissues or cell(s) as foreign or abnormal. The white blood cells in your circulation then attack these tissues, causing inflammation and damage. This damage causes the tissues to function abnormally, producing symptoms. Autoimmune disease can affect the thyroid gland, the joints, and even the ovaries. An autoimmune attack on the ovaries can reduce your ovarian reserve (i.e. lower the number of eggs remaining in your ovaries). Diminished ovarian reserve results in infertility and early menopause.
Do I need to be tested?
If you are struggling with infertility or recurrent miscarriage, you may need to be evaluated for some autoimmune diseases:
Decreased Ovarian Reserve – All women who have infertility should have their ovarian reserve tested. Initially, two hormone levels will be evaluated – FSH (follicle stimulating hormone) and AMH (antimullerian hormone). If these levels are abnormal for your age, then you have diminished ovarian reserve which could have an autoimmune cause. Tests for other autoimmune diseases may need to be performed depending on the severity of your diminished ovarian reserve.
Thyroid Disease – Autoimmune thyroid disease is common in women. We know that even mild thyroid disease can reduce pregnancy rates and increase miscarriage risk. Thyroid disease should be ruled out in all women with infertility.
Antiphospholipid Antibody Syndrome – Women with a history of recurrent miscarriage or placental abruption may need tested for Antiphospholipid Antibody Syndrome. This is an autoimmune disease in which antibodies are produced against one of the components of placental tissue, increasing the risk of blood clots within the placenta, and other pregnancy complications.
Anti-sperm Antibodies – Men can create antibodies to their own sperm which may reduce the sperm’s motility and/or ability to fertilize an egg. These antibodies are typically found in men with a history of significant testicular trauma or testicular surgery such as vasectomy, vasectomy reversal, or varicocele repair.
Can autoimmune diseases be treated?
If you are diagnosed with an autoimmune disease, treatment of the specific disease should be started. Sometimes getting the autoimmune disease under control can improve fertility. In other situations, additional fertility treatment may be required to improve the chance of pregnancy and/or lower the risk of miscarriage.