What is reproductive immunology tests and treatment?

Reproductive immunology is a field of study that looks at how a patient’s immune system reacts when they become pregnant.

Usually, your immune system works by fighting off any invading cells that it doesn’t recognise because they don’t share your genetic code. In the case of an embryo, the immune system learns to tolerate it even though it has a different genetic code from the mother.

Some scientists believe that in some cases of miscarriage or infertility, the mother’s immune system may fail to accept the embryo due to differences in their genetic codes.

Risks of reproductive immunology tests

There are various treatments associated with reproductive immunology which are used to suppress the body’s natural immunity, and all of which have risks:

• Steroids (e.g. prednisolone): Risks include high blood pressure, diabetes and premature birth.
• Intravenous immunoglobulin (IVIg): Side effects can include headache, muscle pain, fever, chills, low back pain, and rarely thrombosis (blood clots), kidney failure and anaphylaxis (a bad allergic reaction to the drug).
• TNF-a blocking agents (eg adalimumab, infliximab): Remicade is not recommended for use during pregnancy. Side effects can include infections including septicaemia, chronic infections such as tuberculosis, and severe allergic reactions to the drug.
• Intralipid infusions: Side effects include headache, dizziness, flushing, nausea and the possibility of clotting or infection.

Evidence

Some recent studies have looked at:

• raised levels of autoantibodies in patients with recurrent implantation failure,
• use of hCG activated white blood cells in patients with recurrent implantation failure,
• the effects of anti-oxidants on cytokine levels in recurrent implantation failure
• adjuncts such as steroids and immunoglobulins on live-birth rates
• intravenous immunoglobulin G on Th17 and Trg cells in recurrent miscarriage

Although research continues into reproductive immunology, currently the adverse effects of some of these treatments, particularly TNF-α, IVIg, outweigh any possible benefits.

Current HFEA grading

For more information, please visit the HFEA website