Auto-immune diseases (systemic lupus erythematosus, anti-phospholipid syndrome, undifferentiated connective tissue disease) accounts for up to 10% of unexplained infertility. In the last 20 years, aspecific auto-immunity, defined as positivity of auto-antibodies in blood sample without clinical or biological criteria for defined diseases, has been evoked in a subpopulation of women with difficulty conceiving, including multiple IVF failures. Thyroid auto-immunity which affects thyroid function could be a cause of infertility; even in euthyroidia, the presence of anti-thyroperoxidase antibodies and/or thyroglobulin are related to infertility. The presence of anti-phospholipid (APL) and/or anti-nuclear (ANA) antibodies seems to be more frequent in the population of infertile women; serum auto-antibodies are associated with early ovarian failure, itself responsible for fertility disorders.
The interplay between female fertility and autoimmune diseases can involve specific genes (HLA haplotypes) and micronutrients. Predisposing DQ2 alleles are independent risk factors for autoimmunity and vitamin D deficiency in the infertile or sub-fertile population and could represent biomarkers for performing early detection of women requiring individually tailored management.
A fine-tuning of complement activation is required from a physiological progression of pregnancy, from pre-implantation stages, through placentation to labor. Complement deregulation has been implicated in several pregnancy complications, such as recurrent abortion, eclampsia and premature birth; low complement levels have been shown to reliably identify women at risk of complications.
Our practice is very experienced in performing an in-depth evaluation of underlying autoimmune conditions that may affect fertility, utilizing several national and specialized clinical laboratories. If signs of autoimmunity that may affect fertility are detected, a tailored therapeutic plan can be implemented, in close collaboration with fertility experts.