Can autoimmune diseases impact your fertility? An expert answers

Having an autoimmune condition can be a big cause of fertility issues among women. But what is the best way to tackle it?
Infertility can take a mental toll on you. Image courtesy: Shutterstock
Dr Pallavi Prasad Updated: 30 Oct 2023, 11:21 am IST
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Having an autoimmune disease increases the risk of infertility among both men and women. This is because the immune system is critical for the optimal functioning of the body, including the reproductive organs. In case you are already aware of your condition and would want to plan a family, it’s advisable to start the conversation early with your doctor.

What are autoimmune diseases?

Autoimmune diseases are certain conditions in which the body’s immune system attacks the healthy cells and tissues, perceiving them as foreign or abnormal. Instead of attacking any harmful foreign bodies, the immune system starts attacking healthy tissues by creating antibodies against them.

These diseases can affect several parts of the body including the joints, thyroid gland and ovaries. There are more than 80 autoimmune conditions that affect the human body. Some of the most common ones are:

* Type 1 diabetes
* Systemic lupus erythematosus (SLE)
* Inflammatory bowel disease (IBD)
* Graves’ disease
* Pernicious anemia
* Celiac disease
* Psoriasis

Can autoimmune diseases impact fertility?

Autoimmune diseases can affect your fertility. Women can have issues when it comes to the implantation of embryos.

A normally-functioning immune system will perceive the embryo as a foreign body initially. But later, the mother’s immune system starts protecting the embryo from attack by other foreign bodies. This is not the case among women with autoimmune diseases. The immune system fails to recognize the embryo and starts attacking it, causing frequent miscarriages. Such conditions can also affect your ovaries, reducing the ovarian reserve or the number of remaining eggs in the ovaries. This can cause early menopause and infertility.

Get tested, if you are unable to conceive

If you are unable to conceive for a long time, you should get tested for some autoimmune conditions. These are:

1. Anti-sperm antibodies:

The immune system in men can create antibodies that damage or reduce the motility of the sperm. This happens due to a testicular injury or surgery like a vasectomy. Ask your partner to get checked.

2. Thyroid disease:

Thyroid is a common condition among women that increases the risk of miscarriages and reduces the rate of successful pregnancies.

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3. Decreased ovarian reserve:

Women who are not able to conceive must get their ovarian reserve tested. If the levels of two hormones – FSH (follicle-stimulating hormone) and AMH (anti-mullerian hormone) are abnormal, it means that the ovarian reserve has decreased, which can be due to an underlying autoimmune condition. Depending on the severity, the doctors will suggest other tests.

4. Antiphospholipid Antibody Syndrome (APLAS):

In this condition, women produce abnormal antibodies which cause clotting, leading to placental abruption, recurrent miscarriages, and premature births.

5. Rheumatoid arthritis:

Rheumatoid arthritis is a chronic form of arthritis that causes inflammation, pain and swelling in joints and bones. The medications for this condition can cause infertility and issues during pregnancy like premature birth and birth defects.

6. Systemic lupus erythematosus:

The disease affects all parts of the body, like skin, kidneys etc., by damaging tissues throughout the body. This can lead to some pregnancy-related complications like low birth weight, miscarriage and high blood pressure disorders like preeclampsia. Many women also suffer from premature births.

Treatment of infertility caused by autoimmune diseases

If you are diagnosed with an autoimmune disease, seeking treatment for the condition can improve fertility. Controlling the symptoms of autoimmune diseases can increase the chances of successful pregnancies. Couples concerned about the impact of autoimmune conditions on fertility should seek medical advice from experts to minimize the risks.


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About the Author

Dr Pallavi Prasad, Fertility consultant, Nova IVF fertility, Bangalore ...Read More

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