How Autoimmune Diseases Affect IVF Success
Autoimmune diseases – such as hyperinsulinemia, hyperprolactinemia, hypothyroidism, endometriosis and more – can cause recurrent IVF failure. During a live webinar on myivfanswers.com, Dr Antonio Rodrigues, a reproductive medicine specialist and a founder and director of Medfem Fertility Clinic in Sandton, Johannesburg, South Africa, explained how this happens.
Read more about autoimmune diseases and their impact on IVF success below, or click here to watch the full hour-long webinar.
The majority of failed IVF cycles are related to abnormal embryos, as well as embryos failing to implant successfully in womb. It may be surprising to many people to learn that autoimmune diseases can play a significant role in recurrent IVF failures. This is because high levels of insulin (hyperinsulinemia) or prolactin (hyperprolactinemia), as well as thyroid disease (hypothyroidism) and endometriosis – affect the two essential factors for a successful IVF cycle.
In this article, we look at the two essential factors for a successful IVF cycle, as well as how autoimmune diseases affect these two essential factors.
The two essential factors for a successful IVF cycle
The two essential factors for a successful IVF cycle are: healthy embryos; and a hospitable uterine environment in which embryos can implant successfully.
1. Healthy embryos
An embryo is an egg cell that has been fertilised by a sperm cell. Healthy embryos are only possible with healthy eggs and healthy sperm. In medical terms, healthy embryos are also known as ‘chromosomally normal’ or ‘euploid embryos’.
Studies have shown that as many as 50% of fertilised eggs or embryos are chromosomally abnormal. If transferred into the uterus during IVF treatment, these chromosomally abnormal embryos are likely to fail to implant in the uterus or may result in a miscarriage.
2. A suitable uterine environment
For a healthy embryo to successfully implant into the uterus lining, a suitable uterine environment is essential, both anatomically and immunologically.
A focus on getting these two basic factors right – a healthy embryo and a healthy uterine environment – will reduce recurrent IVF failures and improve pregnancy rates.
Unfortunately, with today’s modern lifestyles, autoimmune diseases are widespread, including hyperinsulinemia, hyperprolactinemia, hypothyroidism and endometriosis.
The effect of autoimmune diseases on healthy embryos
As we’ve noted, healthy embryos – chromosomally normal or euploid embryos – are only possible with healthy eggs and healthy sperm.
The correct levels of insulin and prolactin – in both the male and female partners – are critical for healthy sperm and healthy eggs, and therefore for healthy embryos. Unfortunately, large numbers of people suffer from autoimmune diseases such as hyperinsulinemia and hyperprolactinemia, which will certainly negatively impact the quality of their eggs and sperm.
Healthy eggs are not the norm, even in healthy women. In fact, an astounding 60 percent and more of a women’s eggs are abnormal under usual circumstances. The same applies to men: large amounts of abnormal sperm are found in every semen sample. Autoimmune conditions such as hyperinsulinemia and hyperprolactinemia will further reduce the possibility of producing healthy eggs and healthy sperm.
High insulin levels have been proven to negatively affect both the quality of a women’s eggs and a man’s sperm. In fact, high insulin levels can even transform a chromosomally normal egg or sperm into an abnormal egg or abnormal sperm, and a normal embryo into an abnormal embryo that will not implant successfully.
The same goes for prolactin, which is a hormone naturally produced by a woman’s body when she is pregnant and breastfeeding. It is a natural contraceptive, as raised prolactin levels reduce the production of the hormones FSH and LH, both critical for a pregnancy, and also cause problems with regard to the thinning in the lining of the uterus. Prolactin levels can also be raised in men, and this causes abnormalities in the semen.
Effect of autoimmune diseases on healthy uterus
Creating an environment for successful embryo implantation is another critical factor in a successful IVF cycle. Autoimmune diseases such as thyroid disease and endometriosis can negatively affect the uterine environment – both anatomically and immunologically.
A pregnancy only occurs if the embryo can implant itself into a healthy, nutrient-dense uterine lining with no physical or anatomical problems that can prevent an embryo from implanting, such as fibroids pushing on the lining, polyps (abnormal tissue growths) in the uterus or endometriosis, which occurs when the tissue that normally lines the inside of the uterus, called endometrium, grows on other parts of the body.
A pregnancy can also only happen if the embryo can implant itself into an immunologically normal uterus.
To understand what this means, it is necessary to know that sperm is recognised by the body as an antigen. This means is that if sperm was detected in the bloodstream of a person, the person’s body would recognise it as an antigen and create an immune reaction. A healthy uterus, however, produces blocking antibodies that prevents the body from reacting to the embryo, which is partly sperm, as an antigen and rejecting it, and instead allows it to implant successfully. If a women’s immune system is not functioning properly, these blocking antibodies are not produced and the presence of sperm can cause immune factors called tumor necrosis factors, which lead to the embryo being rejected.
How to improve your chances of IVF success
Abnormal embryos, as well as embryos failing to implant successfully in womb, are two of the main reasons why IVF cycles fail.
As autoimmune diseases have a significant role to play in the quality of the embryos and the uterine environment, the likelihood of recurrent IVF failures can be reduced by addressing autoimmune diseases prior to IVF treatment to ensure both healthy embryos and a healthy womb.
At Our team at Medfem Fertility Clinic believes in making world-class fertility treatments available for everyone. It is our joy and commitment to give you a positive outcome to your fertility journey, so you will have a fond memory of feeling empathy, caring and being part of the Medfem Fertility Clinic family.
For this reason, our team at Medfem Fertility Clinic goes to great lengths to ensure we cover every eventuality to ensure you have a positive outcome. Understanding the impact of autoimmune diseases on IVF success rates, we test both male and female partners for autoimmune diseases and aggressively manage these issues before any IVF treatment commences, to ensure a highest chance of conception.
In addition, we use high-tech methods to perform embryo screening for genetic and chromosomal information. These new techniques of embryo genetic analysis can indicate the chromosomal status of each embryo, making it possible to screen eggs and embryos for specific abnormalities.
To improve the chances of success of an IVF cycle and to prevent chromosomally abnormal embryos being transferred during IVF, embryo testing techniques are used for the testing of early-stage embryos. This allows our fertility specialists to select high-grade embryos for transfer, thereby reducing the risk of pregnancy failure and improving the chances of having a healthy baby.
The most common embryo testing techniques are pre implantation genetic diagnosis (PGD) and pre implantation genetic screening (PGS). PGD involves detection of single gene disorders and PGS involves the detection of chromosomally abnormal embryos that result in IVF failure, miscarriages or babies born with Down’s syndrome (Trisomy 21) or Edward’s Syndrome (Trisomy 18). The term “pre implantation” is used because testing is performed on embryos during the time before they implant into the uterus.
If you would like to know more about autoimmune diseases and their effect on fertility, or if you are concerned that you have an autoimmune disease that is affecting or could affect the success of your IVF treatment, we would be happy to answer your questions.
To meet one of our fertility specialists at Medfem Fertility Clinic, simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.
We look forward to meeting you!