Reproductive Immunology

What is Reproductive Immunology?

Reproductive immunology is the specialty within Gynecology and Obstetrics in charge of the study, diagnosis and treatment of the alterations of the immune system, as well as the repercussions that they can cause in pregnancy or in the attempt to achieve it.

The immune system is very important in the formation of the placenta and in the nesting of the embryo. In particular, it is responsible for regulating and tolerating the changes that occur after fertilization. Hence, if there is a failure in this regulation or a lack of tolerability in the immune mechanisms that take place during pregnancy, problems can occur, which are:

  • Early miscarriage
  • Late miscarriage or loss of the fetus.
  • Pathological pregnancy with risk for the baby or the mother.

The immune system is the biological structures and processes that protect the body from foreign cells. It is the lymphocytes and antibodies that protect us from bacteria, parasites or viruses, and even altered own cells. However, it sometimes reacts in the wrong way to normal cells, leading to their destruction and thus to autoimmune diseases. In the case of pregnancy, the immune system has to accept cells that it would consider “foreign”, since the embryo will have a different immune system from that of the mother. A local inactivation then occurs where the placenta of the embryo invades the maternal tissues without rejection by the mother’s immune system (the mother is immunized). Thus, embryo implantation and pregnancy development depend on a balance of tolerance between the baby and the mother (immunologically distinct). When this fails it can be a cause of sterility.

Reproductive immunology studies alterations of the immune system and the repercussions
and the repercussions they can have on pregnancy.

Why is it performed?

There are a number of immunological factors responsible for a percentage of cases of sterility/infertility. However, it is possible to act on them therapeutically. Some diseases of immunological origin are very important in reproductive failure, but also during pregnancy.

In the case of couples who cannot become pregnant, a study, evaluation and treatment is very important in order to analyze whether the infertility may be of immune origin. It is estimated that 10% of implantation failures or cases of repeated miscarriages may be due to some alteration in the mother’s immune system.

Therefore, reproductive immunology deals with the study of the possible influence of diseases or immunological factors on the achievement or failure of pregnancy, in order to establish an effective treatment.

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What does it consist of?

In couples who cannot become pregnant, first of all, it will consist of a complete profile of immunological factors related to primary infertility, repeated miscarriages, implantation failure after In Vitro Fertilization (IVF) and cases of preeclampsia. In these cases a blood test will be performed to assess the body’s immune capacity to embryo implantation.

Likewise, in women in whom a possible immunological cause is suspected, other studies should be carried out and, after a correct selection, an immunomodulator treatment will be applied. These are treatments that should be premeditated and advised by the specialist in Gynecology and Obstetrics and the specialist in Immunology. Although there is not 100% clear scientific evidence regarding these treatments, there are good results in well selected patients. That is why the previous study is very important. Any drug may involve risks associated with side effects. The drugs used for immune pathologies identify the risks well. However, in pregnant women, individual risk factors should be well identified and a good immunological control should be performed in order to minimize and avoid such side effects.

Preparation for reproductive immunology

The specialist will recommend to the patient or the couple what to do in each case, depending on the phase they are in: if they are not yet pregnant or if the patient is pregnant.

Also, depending on the immunological alteration you are suffering from, certain tests or examinations may be required which, in turn, require certain preparation. The doctor will always be the one to advise you on the steps to follow.

In any case, the most important preparation before undergoing a reproductive immunology treatment will be the necessary preliminary tests. These will serve to identify the immunological cause of the problem and thus establish the most appropriate treatment.

Care after the procedure

The specialist will recommend to the patient or couple what steps to follow after the reproductive immunology treatments. Depending on the causes of the problem they suffer, one treatment or another will be established, and the subsequent care will depend on this.

Alternatives to this treatment

There are no alternatives to reproductive immunology treatment. The studies will not be the same for all women and all couples, but the reproductive immunology itself has no variants.