Couples experiencing difficulties conceiving and maintaining pregnancies are often left with few clues as to the source of the problem. Even with the help of their health care provider, solutions can be hard to find without digging deeper.
In my online fertility and pregnancy programs, I share the research linking fertility challenges and recurrent pregnancy loss to auto-immune diseases like lupus, Hashimoto’s and anti-phospholipid syndrome. Now, new research from China’s Anhui Medical University has linked another auto-immune disease – Sjogren’s Syndrome – with adverse IVF and pregnancy outcomes, including recurrent pregnancy loss.
With auto-immune diseases, the immune system mistakenly produces antibodies against healthy tissues (an “immune reaction to self”). These auto-antibodies can result in inflammation of specific tissues, and also general inflammation that can affect all stages of fertility, including egg (and sperm) quality, implantation failure and pregnancy loss.
The most common symptoms of Sjogren’s Syndrome are dry eyes and dry mouth – but there are also systemic inflammatory effects because of higher levels of blood cytokines, and lower levels of blood Th and NK cells. When the Chinese study looked specifically at IVF outcomes, it was found that those in the Sjogren’s group had lower retrieved oocytes (how many eggs are retrieved), lower blastocyst formation rate (how far along the fertilized embryo develops in the lab before implantation), lower pregnancy rate and lower take-home baby rate.
Pregnancy complications from natural conceptions with mothers who have Sjogren’s Syndrome have also been demonstrated to have higher rates of miscarriage, preterm delivery, congenital heart block, and pre-eclampsia.
It makes sense then, that auto-immunity screening should be part of a general fertility workup. Labs to consider would be:
- ANA (anti-nuclear antibodies), which if positive would trigger an ENA test (extractable nuclear antigen) that would look for 7 different proteins, in the bode including anti-SSA and anti-SSB (linked with Sjogren’s) and anti-Sm (linked with lupus)
- TPO and anti-thyroglobulin antibody (linked with Hashimoto’s)
- Anticardiolipin antibodies IgG and IgM (linked with anti-phospholipid syndrome)
Getting to the true source of patients’ fertility issues can take time, but solving the puzzle can make all the difference!
I hope you have found this helpful, and do let me know if you have any questions!
If you are hungry for more evidence-based information for your fertility or pregnancy journey, visit www.myhealthypregnancyplan.comfor free webinars and complete programs.
And if you are a care-provider looking for evidence-based resources for your fertility or pregnancy patients, please get in touch with us at support@myhealthypregnancyplan.com, or visit www.myhealthypregnancyplan.com/ce-courses-for-naturopathic-doctors.
In health,
Dr Jocelyn Land-Murphy, ND
Terra Life
Disclaimer: The information and content provided is for general educational and informational purposes only and is not professional medical advice, nor is it intended to be a substitute therefore. Please consult the Disclaimer and Terms of Use for full details.
References:
Fang, X. et al. (2022). Anti-Ro/SSA and/or anti-La/SSB antibodies are associated with adverse IVF and pregnancy outcomes. Journal of Reproductive Immunology, 149.