Despite very effective treatment options, not every fertility treatment is successful. Sometimes women become pregnant but repeatedly suffer miscarriages. The causes of recurrent pregnancy loss (also called recurrent miscarriage or habitual abortion), which usually occur in the early stage of pregnancy, are complex. In about half the cases, it is not possible to give a clear reason for the habitual abortions. If genetic disorders, infections and tumours can be excluded as the cause, there is the possibility that infertility is caused by immunological problem.
The role of the immune system is to protect the body from infections caused by foreign cells. For example, the white blood cells identify and effectively combat common cold viruses, bacteria and other pathogens. When an egg is fertilised, the father’s genetic material also brings foreign cells into the woman’s body. As an immunological reaction, the body starts producing Fc-blocking antibodies from the time of fertilisation. They surround the embryo like a protective sleeve, suppressing the body’s own immune cells for the duration of the entire pregnancy. If the Fc-blocking antibodies are not formed or not formed in sufficient quantities, there is a high probability that the body will reject the embryo during the course of the pregnancy.
The woman’s body needs to have a natural defensive response in order for it to be able to start producing the protective Fc-blocking antibodies. If the immune response is too weak, the body cannot produce enough antibodies and the embryo is attacked by natural killer cells (NK cells). Studies have shown that an insufficient immune response most often occurs when the cells of a man and a woman are very similar.
On the other hand, fertilisation of an ovum can trigger overreaction by the immune system. When this happens, the body produces large quantities of killer cells in a short period of time; these attack the embryo and thus greatly increase the risk of miscarriage.
We offer an immunological consultation at our centres that focuses on immunological causes for an absence of pregnancy after IVF. We focus on your individual situation and analyse all the potential causes, such as genetic, infectious, endocrine, haemostaseological, uterine and immunological abnormalities. After diagnosis, we give you our treatment recommendations.
For some of our patients, intravenous immunoglobulin (IVIG) in conjunction with the artificial insemination process has proven effective. If previous IVF-ICSI treatments were unsuccessful, we start with infusion treatment before inserting the embryo. If a patient has suffered recurrent miscarriages without artificial insemination, we start treatment at three-week intervals as soon as there is a positive pregnancy test and continue it up to the 24th week of pregnancy.
In our experience, pregnancy rates and birth rates increase significantly with immune therapy where there is a history of implantation failure in IVF-ICSI treatment, and it also significantly reduces the risk of another miscarriage in patients with a history of recurrent miscarriages.
Intravenous – i.e. externally administered – immunoglobulins (IVIG) work in the same way as the antibodies that a healthy body produces naturally. They are administered to support and/or regulate the immune system, as is done with auto-immune diseases.