Overcoming Autoimmune-Related Infertility

What is Autoimmunity?

Autoimmunity occurs when your body’s immune system mistakenly attacks your own healthy cells and tissues. In a properly functioning immune system, the body can distinguish between foreign invaders and its own cells. However, in autoimmune conditions, this ability is compromised, leading to various health problems.

Think of it this way: Your immune system is like a bouncer at the hottest nightclub in town. Its job is to keep the troublemakers (bacteria, viruses, etc.) out while letting the VIPs (healthy cells) enjoy the party. But sometimes, this bouncer gets a bit overzealous and starts turning away the good guys, too. That’s autoimmunity in a nutshell.

The statistics about autoimmune disorders are staggering:

• According to the National Institutes of Health, autoimmune diseases affect an estimated 23.5 million Americans. (2) That’s about 7%!
• However, some researchers believe this number could be as high as 50 million, which is more like 15%! (3) 
• There are more than 100 known autoimmune diseases. (3) Approximately 10 to 15 are directly associated with fertility issues or have a significant impact on reproductive health (keep reading for more details!)
• Women are disproportionately affected, with females accounting for about 80% of autoimmune cases.
• Autoimmune diseases are among the top 10 leading causes of death for women of childbearing age. (4) This is because autoimmune disorders and the conventional treatments for them can lead to severe organ damage, immunocompromised infections, blood clots, heart disease, and cancer, among other fatal issues.

How Autoimmunity Impacts Fertility

While autoimmunity and infertility might seem like separate health issues, research has uncovered significant connections between the two. They’re like two branches growing from the same tree.

Commonality #1: Inflammation. 

Both autoimmune conditions and infertility often involve chronic inflammation. In autoimmunity, inflammation is a key driver of tissue damage, while in infertility, it can interfere with multiple aspects of reproductive health, such as sperm quality and production, ovulation, implantation, and maintaining a pregnancy. (5, 6)

Commonality #2: Hormonal Imbalances.

Autoimmune diseases can disrupt the endocrine system, leading to hormonal imbalances. Similarly, hormonal imbalances are a common cause of infertility. For example, Polycystic Ovary Syndrome (PCOS) is a known fertility blocker caused by hormonal imbalances, and it is often associated with conditions like thyroid autoimmunity.

Commonality #3: Oxidative Stress.

Both autoimmunity and infertility are associated with increased oxidative stress, which can damage cells and tissues, including those involved in reproduction. (7) Common sources of oxidative stress in women of reproductive age include environmental toxins, poor diet, smoking, and chronic stress.

Commonality #4: Genetic Factors.

There’s evidence that both autoimmunity and infertility have genetic components, with certain genes increasing susceptibility to both conditions. (8) For instance, mutations in the HLA (human leukocyte antigen) genes—which are responsible for regulating the immune system’s ability to distinguish between self and non-self cells—have been linked to a higher risk of autoimmune diseases and recurrent miscarriage. (9)

Commonality #5: Environmental Triggers.

Both autoimmune diseases and infertility can be influenced by environmental factors such as toxins, stress, and dietary choices. (10) For example, exposure to endocrine-disrupting chemicals like BPA and phthalates can interfere with hormone regulation, increasing the risk of infertility and autoimmune conditions.

Commonality #6: Gut Microbiome Imbalances.

An imbalance in gut bacteria (dysbiosis) is linked to autoimmune diseases and can also affect fertility. Dysbiosis can lead to inflammation and hormone disruption, impacting sperm quality, ovulation, and pregnancy outcomes. In women, conditions like endometriosis and premature ovarian insufficiency have been linked to gut microbiome imbalances, while in men, poor gut health can impact sperm motility and overall reproductive function.

Commonality #7: Dietary Factors.

Certain foods can trigger inflammation and autoimmune responses, which may also affect fertility. (11) Diets high in processed foods and sugars can increase oxidative stress and disrupt hormone balance, while anti-inflammatory diets—such as the Mediterranean diet—can improve fertility. Additionally, for those who have celiac disease, eating gluten can trigger an autoimmune response that interferes with hormone balance and fertility.

Autoimmune Conditions Linked to Infertility

Several autoimmune conditions have been directly linked to fertility problems in both men and women:

1. Thyroid Autoimmune Diseases: Conditions like Hashimoto’s thyroiditis and Graves’ disease can disrupt thyroid function, which is crucial for reproductive health. These thyroid issues can affect ovulation, fertility, and overall pregnancy outcomes.
2. Type 1 Diabetes: This autoimmune condition, where the immune system attacks insulin-producing cells, can lead to irregular menstrual cycles, anovulation, and PCOS in women. In men, it may cause erectile dysfunction, retrograde ejaculation, and reduced sperm quality, all of which can affect fertility.
3. Rheumatoid Arthritis (RA): While rheumatoid arthritis itself doesn’t directly cause infertility, some of the medications used to manage RA, particularly those that suppress the immune system, can have side effects that impact fertility in both men and women.
4. Celiac Disease: Undiagnosed celiac disease has been associated with a range of reproductive issues, including infertility and pregnancy complications, in both men and women. The autoimmune response triggered by gluten in celiac disease can interfere with reproductive hormones and the body’s ability to sustain a pregnancy.
5. Systemic Lupus Erythematosus (SLE): SLE can complicate fertility by affecting the kidneys and other organs, and it also increases the risk of pregnancy complications, such as preterm birth and preeclampsia.
6. Antiphospholipid Syndrome (APS): APS is a condition that can significantly increase the risk of recurrent miscarriage and other pregnancy complications, making it a major concern for women trying to conceive.
7. Premature Ovarian Insufficiency (POI): POI, also known as early menopause, can have an autoimmune origin, reducing ovarian reserve. (12) Women with autoimmune diseases like systemic lupus erythematosus (SLE) face higher POI risk. Early management is crucial, potentially involving egg freezing or assisted reproductive technologies.