Autoimmune Diseases: – How Do They Affect Fertility?

By (embryologist).
Last Update: 04/01/2016

Autoimmune diseases are diseases in which the immune system reacts in the wrong way by attacking and destroying healthy body cells and tissues.

Currently, more than 80 autoimmune diseases are known in humans. In this article we talk about some of them.

The different sections of this article have been assembled into the following table of contents.

Different types

There are two types of autoimmune diseases depending on the number of organs that may be affected:

  • Organ-specific: affects a specific organ that will depend on the type of disease.
  • Systemic: any organ can be affected, affecting multiple organs or systems at the same time.

Systemic diseases include lupus erythematosus and rheumatoid arthritis, while in celiac disease damage is localized to a single organ.

Why are they produced?

The cause of autoimmune diseases is unknown, we don’t know why the body sometimes attacks itself. However, it is known that there are certain factors that can influence the development of this type of disease.

A genetic predisposition is necessary for an autoimmune disease to develop. These diseases are not genetic, they are not inherited, but there are combinations of genes that produce an increased risk of developing an autoimmune disease. Depending on the genes that are affected, there will be a predisposition towards one or the other disease.

In addition to genetic predisposition, environmental factors also play a role. These are necessary to trigger the activation of the immune system. These include hormonal changes, tobacco, alcohol, vaccines, infections, eating disorders, etc.

How to diagnose an autoimmune disease?

The manifestation will depend on the type of disease and the organs that are affected, although there may be variations even in cases with the same disease.

The characteristic symptom of an autoimmune disease is inflammation. Any inflammation causes redness, pain, swelling and warming of the affected area. Other common symptoms that often appear are malaise, fever, and fatigue.

Because the clinical pictures are so varied it is difficult to give a diagnosis. In order to diagnose an autoimmune disease, an examination of the patient’s medical history and the patient’s symptoms must first be performed. Afterwards, a blood test must be performed, where inflammation markers and autoantibodies can be studied.

Autoantibodies are antibodies produced by the body against itself, while inflammatory markers are those molecules that are usually present in inflammation processes and can therefore be used to predict the risk of autoimmune disease.

What to Expect from Treatment

Once diagnosed, autoimmune disease can be treated to achieve these goals:

  • Reduce symptoms
  • Controlling the autoimmune mechanism
  • Maintain the body’s ability to fight disease

However, autoimmune diseases have no cure, they are chronic, since it is not known where exactly the problem lies.

Treatment will depend on the type of autoimmune disease. Immunosuppressive drugs, which reduce the immune system’s response, are often given. These medicines are usually administered in systemic autoimmune pathologies and their use should be monitored so as not to leave the body without defences.

The most commonly used drugs include corticosteroids, such as prednisone, and non-steroidal drugs, such as cyclophosphamide. Tumor necrosis factor (TNF) blockers may also be given in certain cases.

In autoimmune diseases specific to an organ, treatments adapted to the affected organ are carried out.

Autoimmune diseases and fertility

In women with certain autoimmune diseases, there may be difficulties in having offspring. Pregnancy can be considered risky because it puts the mother’s life and that of the baby at risk due to the possibility of serious complications.

This is the case with rheumatoid arthritis and systemic lupus erythematosus. Women with these diseases may need to resort to surrogacy treatment to become mothers without risking their lives.

On the other hand, other autoimmune-based diseases do not affect fertility and, in fact, some of them, such as multiple sclerosis, remit during pregnancy. However, after childbirth there may be an increase in outbreaks due to the disappearance of the protective effect that this state has on the disease.

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Authors and contributors

 Sara Salgado
Sara Salgado
Embryologist
Degree in Biochemistry and Molecular Biology from the University of the Basque Country (UPV/EHU). Master's Degree in Human Assisted Reproduction from the Complutense University of Madrid (UCM). Certificate of University Expert in Genetic Diagnosis Techniques from the University of Valencia (UV). More information about Sara Salgado

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