Reproductive immunology - who to believe?

by dee armstrong

Couples could be forgiven for not knowing which way to turn when it comes to the debate around the controversial new field of reproductive immunology - in other words can you be 'allergic' to pregnancy as it were, causing your body to reject an embryo?  On the one hand a range of new tests and treatments are offered by elite fertility clinics with seemingly high success rates and on the other experts such as Prof Robert Winston and Prof Lesley Regan are sceptical to say the least, saying that the treatments are based on poor science.

Natural killer cell

Natural killer cell

It's important to remember that scientific progress is often a bumpy road and change can be glacial.  Profs Barry Marshall & Robin Warren discovered the link between stomach ulcers and a specific bacteria in the late 1980's but were shouted down by scientist colleagues around the world who clung to the long held view that ulcers were caused by stress - it took ten years for their discovery to begin to change the way ulcers were treated and another ten years before Marshall was awarded the Nobel Prize for Medicine.

Dr David Servan-Schreiber, writer of the amazing book Anti-Cancer, makes points that are just as relevant in the ever changing field of fertility.  He says that physicians are constantly looking for scientific advances, they go to conferences, read journals and meet drug company representatives to find out the latest new advances that are on the market.  "They feel they are aware of everything going on in their field and generally they are.  But in medical culture, changes in recommendations given to patients are allowable in one case and one case alone: when there has been a series of 'double blind' studies demonstrating the effectiveness of a treatment in humans. This is called, legitimately, 'evidence based medicine'."  However, he goes on to point out that experts often don't agree amongst themselves, especially during the research phase in a particular area.  In addition he says that one of a physician's "greatest worries is not to give false hopes.  We have all learned that nothing is more painful for a patient than the feeling of having been betrayed by ill-considered promises."  Because of all these legitimate concerns, he says, "my colleagues are sometimes tempted to refuse out of hand all approaches outside the confines of existing conventional practices."   

When I first went to The Fertility Show in London five years ago, women who raised their hands to ask whether natural killer cells could be playing a part in their infertility were swiftly dismissed by the expert speakers and advised not to spend too much time looking up outlandish theories on the internet. Two years later and the immunology proponents were sharing a platform with the naysayers and speaking to packed out seminars.   At the Natural Fertility Centre, we are open to the idea that immunology may play a part, and patients of ours have been successful after consulting doctors like Dr Mohamed Taranissi and Dr Amin Gorgy in London. We also have a great deal of respect for Jill Blakeway who runs the very successful Yin Ova Centre in New York  - Blakeway says she has "been in practice for many years. Long enough to notice trends, and one of the things that I have noticed is a rise in autoimmune problems (allergies, lupus, Crohn’s disease, rheumatoid arthritis, chronic fatigue and some kinds of thyroid disorders). What concerns me about this rise in immune system dysfunction is the effect it has on fertility. Endometriosis, recurrent miscarriage and failed IVF are common problems for women who have autoimmune issues and in our book Making Babies: A Proven 3-Month Program for Maximum Fertility Dr. David and I talked about how we thought immunity issues were the third most commonly overlooked cause of infertility, after endometriosis and infections..."

"... Chinese medicine, when applied correctly can be very helpful in treating a misbehaving immune system... You may think that the best way to handle an immune issue is to boost the immune system. That’s what a practitioner would do if you caught colds all the time or had some other sign of immune deficiency. But simply making the immune system stronger when it’s already hyperactive, is a mistake. What we really aim to do is to bring your immune system back into balance, not turbocharge it. This is a job for an experienced herbalist, who has the skills to adapt a herbal formula as your internal landscape shifts. "

The HFEA has put together a helpful page about Reproductive Immunology. I would endorse their suggested list of questions to discuss with your doctor before embarking on a course of immunology treatment: 

  • Why do you think I need this treatment - can you explain what you think is happening in my body? 
  • What data or evidence do you have to prove that this treatment will improve my chance of having a baby?
  • What will the treatment involve for me?
  • How much difference do you think having this treatment will make for me? 
  • What are the side effects and risks of the treatment?
  • How much will the tests and treatment cost me?