Infertility is defined as the inability to conceive a child with regular unprotected sexual intercourse which lasts more than a year. Infertility has many causes and one of them is the immune system itself. If there is a problem in its regulation, immunity system creates antibodies against cells or organs which are the body’s own, thus preventing them from their function and damages them. In men are antibodies aimed against sperms, and in women are created antibodies that are also aimed against eggs.
Immune system, composed of many cells, protects us from harmful external influences. Daily, it has to defend us against viruses, bacteria and as well as against physical effects, such as solar radiation, heat or cold. Immune system had developed for a long time to be able to recognize foreign particles and effectively destroy them. However, it must be properly adjusted to recognize the body's own tissues and tolerate them. Unfortunately, this is not always successfully performed, and so variety of autoimmune diseases develops. These are diseases in which are the various organs damaged by their own immune system. So far, no evidence was found to prove why this is so. Some organs are so valuable and immunologically exceptional that they are protected by a special barrier which protects them from immune cells. These organs are the brain, testes and eyes. At even 20% can be infertility caused by immune system itself. We should not look on causations of infertility separately. We must always take into account the hormonal control and environmental factors.
Immunological infertility in men
The most common immune disorder that causes infertility in men is the violation of special barrier which separates the testicles from the immune system. This can happen, for example, due to injury or inflammation after overcome testicular cancer. Immune cells reach the tissues that they previously did not know and start to attack them as foreign. These cells produce antibodies that bind to sperms. This way marked sperms have impaired movement, and so they often do not pass through the mucus in the uterine cervix or they may have difficulties during the penetration of egg.
Immunological infertility in women
For women is the situation different. Sperms are for the female body actually foreign and the immune system does not recognize them. Therefore, in the semen are substances that have the ability to suppress the immune system and increase the chance of sperms to fertilize the egg. A problem may arise, if the partner has not these substances contained in the semen. Another possibility for development of immunological infertility is when the immune system of women overreacts, therefore these substances do not have the chance to dampen it sufficiently. This happens, for example, during repeated inflammation of female sexual organs. Accordingly, immune cells are highly concentrated in genital tract, and produce more antibodies and other mediators that damage sperms. Another cause of immunological infertility may be the creation of antibodies against cells that naturally surrounds and protects the developing egg. This occurs when the egg sample is taken very often. This situation is similar to the one in men, the barrier is broken and immune system encounters with cells that it previously did not know. In that way, bound antibodies can prevent sperms from the penetration of egg. In case of infertility, all women who are already treated for an autoimmune disease must be carefully monitored. For example, in systemic lupus erythematosus are formed antibodies against phospholipids. These are the particles that occur naturally on the cell membrane in the human body. Thus, even in the ovaries. These antibodies can bind on ovarian cells and inhibit the release of eggs, or they can be bound directly to the egg or sperm. Such unwanted immunity either inhibits the egg to nidate in the womb, or it impairs the egg and cause a miscarriage. During pregnancy, these antibodies attack also the epithelium of blood vessels in the placenta and cause formation of blood clots that block arteries. This leads to impaired placental blood flow which can cause fetal growth restriction, miscarriage or premature birth.
Treatment of immunological infertility
Treatment of immunological infertility is domain of dedicated departments which deal with individual cases on the basis of previous specialized examinations. It is necessary to consult these issues with experts who suggest appropriate solutions. Nowadays, there are various possibilities to increase the chances of natural conception. In the case of immunological barrier which inhibits the fertilization of egg can be infertility treated by methods of assisted reproduction. However, if the causation of immunological infertility is in nidation of the egg, it is necessary to suppress the immune system.
Treatment of immunologic infertility in men
In men with immunological infertility, but it is quite individual, are successfully used effects of adrenal cortical hormones, antioxidants and pentoxifylline, together with assisted reproduction. Method in which are sperms purified from antibodies are also used, but this method is being gradually phased out.
Treatment of immunologic infertility in women
For women with immunological infertility is recommended to avoid irritation of the immune system by foreign substances. According to this is essential protected sex with a condom for three months. This way immune system gradually forgets that sperm are to it an enemy. Small doses of immunosuppressive drugs that suppress its reaction can also help. Negative effect of antibodies is limited with medications for blood dilution and to prevent occasional development of blood clots in the placental blood vessels.
Methods of assisted reproduction
In the treatment of immunological infertility are also used methods of assisted reproduction. These include intrauterine insemination, in vitro fertilization and intracytoplasmic injection. In intrauterine insemination (IUI) are obtained male sperms injected directly into the woman's uterus, thereby their contact with the antibodies in the cervical mucus is prevented. Another method is in vitro fertilization (IVF), in this method are harvested sperms injected into the egg that was collected in advance. Afterwards, is the egg returned into the woman's uterus. Third method is intracytoplasmic injection (ICSI), in which is into the oocyte injected only one healthy sperm and the fertilized egg is then put back into uterus.