As couples embark on the important journey of in vitro fertilization (IVF), it is essential that they receive clear and realistic information about their chances of achieving a successful pregnancy and ultimately having a child.
Today, an increasing proportion of women undergoing in vitro fertilization (IVF) have one or more underlying chronic medical conditions.
Hormonal Changes and Their Effects During Menopause
It is particularly noteworthy that a Danish study involving 1,362,200 births found that the prevalence of chronic diseases among women of reproductive age increased from 3.71% in 1989 to 15.76% in 2013 (Jolving LR et al., 2016).
Recognizing Early Symptoms of Menopause
These conditions include autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, autoimmune thyroid disorders (including autoimmune thyroiditis), ulcerative colitis, Crohn’s disease, and diabetes mellitus.
With regard to these conditions, a substantial body of clinical evidence demonstrates that the immune system plays an active role in human reproduction. Immune dysregulation, particularly in the context of autoimmune disease, may adversely affect female fertility.
This association is supported by the following findings:
- The presence of autoantibodies and an imbalance among the various inflammatory cells and mediators—including immune cells and cytokines—has been observed in women with infertility and reproductive disorders
- The frequent coexistence of infertility and autoimmune diseases
- The association between endocrine disorders and autoimmune diseases
- The detrimental effects of autoantibodies and immune mediators on fertility.
Therefore, the impact of various autoantibodies on the outcome of in vitro fertilization (IVF) remains an area of considerable clinical and scientific interest, given that IVF is the most effective and widely used treatment for infertility.
In addition, endometriosis—a chronic gynecological condition affecting approximately 2–10% of women of reproductive age—is now widely considered an immune-mediated disorder with autoimmune features and appears to be associated with an increased prevalence of other autoimmune diseases.
Indeed, studies have demonstrated a statistically significant coexistence of endometriosis with at least one other autoimmune disease. This association is thought to be explained by shared pathophysiological mechanisms and common biological pathways linking endometriosis with other autoimmune conditions.
These shared mechanisms include increased levels of immune cells, reduced cytotoxic activity of natural killer (NK) cells, and a higher prevalence of autoantibodies. In addition, several genes have been identified that appear to contribute to the pathogenesis of both endometriosis and other autoimmune diseases, including PTPN22 and specific HLA alleles.
An important question, based on the available scientific evidence, is how the likelihood of achieving a live birth through assisted reproductive treatment in women with autoimmune diseases compares with that of the general population undergoing in vitro fertilization (IVF).
Do women with autoimmune diseases have lower implantation rates or impaired embryo development compared with women without autoimmune disease?
Protecting Your Health with Early Action
Preventive care plays a crucial role in supporting long-term health by identifying and addressing potential health issues before they become more serious. In this section, explore key health screenings, like mammograms and Pap smears, recommended at different ages, and learn about other essential health checks that every woman should consider. Early detection can make all the difference, empowering women to take control of their health and well-being at every stage of life.
Fueling and Strengthening the Body
Proper nutrition and regular physical activity are the foundation of a healthy life, providing energy, supporting mental clarity, and reducing the risk of chronic diseases. This section offers guidance on key nutrients and balanced diets tailored to women’s unique health needs, covering topics like bone health, heart health, and hormone balance. Additionally, discover fitness routines and exercises designed to build strength, improve flexibility, and support women’s overall wellness, from young adulthood through the later stages of life.
Understanding and Navigating Life’s Changes
Reproductive health encompasses a wide range of topics, including hormonal balance, menstrual health, fertility, pregnancy, and menopause. This section addresses common questions about reproductive health, as well as the management of conditions such as PCOS, endometriosis, and more. Learn how hormones impact your body, ways to support a healthy reproductive system, and what to expect as you transition through different life stages. Knowledge and self-care can help make each stage as healthy and fulfilling as possible.
Several factors are of critical importance, including those related to the underlying disease itself and its treatment—such as disease activity, the degree of systemic inflammation, and the medications used to control the condition. Other key considerations include the endometrial environment and its receptivity, alterations in endometrial inflammatory mediators (cytokines), disturbances of reproductive hormone regulation, and additional contributing factors.
Accordingly, it would be of considerable clinical interest to investigate the relationship between each individual autoimmune disease and reproductive function, as well as its impact on the effectiveness of assisted reproductive treatment.
Jolving LR, Nielsen J, Kesmodel US, Nielsen RG, Beck-Nielsen SS, Norgard BM. Prevalence of maternal chronic diseases during preg- nancy – a nationwide population-based study from 1989 to 2013. Acta Obstet Gynecol Scand. 2016;95(11):1295–1304.
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