Do Autoimmune Diseases Affect Fertility?

When the immune system starts attacking healthy tissue, it can impact every part of your body — including your reproductive system.

Autoimmune diseases are conditions where the body’s immune system attacks healthy tissue, and depending on their specific effects, many autoimmune diseases can negatively impact on fertility. Read on to learn more about the links between autoimmune diseases and fertility, and specific treatments for women looking to conceive while managing symptoms

What Are Autoimmune Diseases?

The immune system is your body’s protector, and it is designed to break down harmful substances that might otherwise cause bodily harm. The term “autoimmune diseases” actually refers to a group of more than 80 conditions in which the immune system is overly active. Instead of attacking foreign bodies, the immune system creates antibodies that attack healthy tissue, leading to inflammation, degeneration, and other harmful symptoms. 

Do Autoimmune Diseases Affect Fertility?

The short answer is yes. The links between autoimmune diseases and infertility are complex, and women with preexisting conditions are at greater risk for infertility than those without them. Given that autoimmune disorders differ from one another, links between autoimmune disorders and fertility also vary.  

When the immune system is functioning normally, it can recognize a pregnancy as a desirable condition within the body, even though the embryo will initially seem foreign. During pregnancy, the body initiates a process by which it redirects the mother’s immune system to protect the embryo from attack by other sources. 

For  women with autoimmune diseases however, the immune system fails to recognize the embryo and attacks the embryo itself. This can cause recurrent miscarriages. In other cases, women with autoimmune diseases might be at risk for decreased ovarian reserve — a condition in which a woman’s ovaries lose their reproductive potential. 

Common Autoimmune Diseases and Fertility

Each autoimmune condition is different. Here a few of the most commonly asked about conditions and how they impact fertility and pregnancy: 

 

  • Systemic Lupus: In lupus, the immune system attacks healthy tissue, causes inflammation and eventually leads to tissue damage throughout the body. The disease affects everything from the skin, kidneys, and blood vessels to the brain. Women with lupus are more likely to experience pregnancy-related complications including miscarriage, low birth-weight, and preeclampsia. Around one-third of women with lupus deliver babies preterm. Fortunately, if women are in remission before conception, they can carry pregnancies to term.

  • Rheumatoid arthritis: This is a chronic form of arthritis that causes inflammation and degeneration in the lining of the joints and bone, as well as pain and swelling. With rheumatoid arthritis and similar autoimmune diseases, some of the medications that are used to treat its symptoms can lead to fertility and problems during pregnancy including birth defects in the fetus or preterm birth. If you are looking to conceive and taking medication for rheumatoid arthritis, make sure to consult your doctor and a fertility specialist about how best to proceed.

  • Scleroderma: When the immune system attacks healthy tissue in scleroderma, the attacks cause the skin and blood vessels to thicken and tighten, and scars to form on the kidneys and lungs. While localized scleroderma only affects the skin, systemic scleroderma affects the organs and connective tissue that bind and support the body’s cells, organs, and tissues. Localized scleroderma rarely affects pregnancy. However, women with systemic forms of scleroderma require additional monitoring during pregnancy because they are at risk for developing preeclampsia, preterm labor, and other kidney problems. 

 

Women and couples who are concerned about how autoimmune diseases might impact their fertility should consult an expert about how to minimize risks. At the Advanced Fertility Center of Texas (AFCT), our fertility specialists can help you determine whether your autoimmune condition puts you at greater risk. They can then help guide you through the next steps on your fertility journey. 

Scientific Research

Luteinizing hormone–independent rise of progesterone as the physiological trigger of the ovulatory gonadotropins surge in the human

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Recipient outcomes in an oocyte donation programme: should very young donors be excluded?

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