Immunological changes can interfere with embryo implantation, but correct diagnosis and specialized monitoring increase the chances of a healthy pregnancy.
The decision to expand your family is generally accompanied by plans, expectations and dreams. But for some couples, the pregnancy doesn’t go as planned, even when the first tests appear normal. In some of these cases, the difficulty of getting pregnant may be linked to a factor rarely discussed outside the office: immunological infertility.
Understanding how the maternal body responds to the presence of an embryo is an important step toward finding safe, individualized, and evidence-based pathways.
What is immunological infertility?
The function of the immune system is to protect the body against external threats. During pregnancy, however, he must make a delicate adjustment: the embryo carries half of the father’s genetic material and can therefore be recognized as something partially “foreign” by the woman’s organism.
When this adaptation does not occur correctly, the body can overreact, making it difficult for the embryo to implant in the uterus or leading to very early losses, sometimes even before the pregnancy is confirmed.
What immunological changes can affect fertility?
Among the main mechanisms involved in this type of infertility are:
- Failure of embryo implantation: the embryo is unable to attach properly to the uterus early in pregnancy;
- Autoimmune processes: the body produces antibodies that attack essential structures during pregnancy, such as the placenta, causing inflammation and harming embryonic development;
- Thrombophilias: changes in blood clotting, whether hereditary or acquired, that increase the risk of recurrent miscarriage and complications during pregnancy.
These conditions are often associated with the diagnosis called “unexplained infertility.”
Tests that help identify the problem
When immunological infertility is suspected, the investigation is more thorough. Among the tests requested are: diagnostic hysteroscopy (which evaluates the interior of the uterus and identifies inflammations, adhesions or polyps that make implantation difficult); evaluation of NK cells (or natural killers, which analyze the behavior of defense cells which, in excess, can attack the embryo); specific immunological tests (detect antibodies that interfere with embryonic attachment) and thrombophilia tests (identify clotting changes that can compromise the placenta and blood flow to the baby).
These examinations help reduce the risk of unexpected miscarriages and guide the most appropriate treatment.
What are the treatment options?
After diagnosis, it is possible to adopt strategies that increase the chances of a healthy pregnancy. Among them:
- Anti-inflammatory drugs in controlled doses: used, in general, until mid-pregnancy to modulate the immune response without harming the baby;
- Specific anticoagulants: indicated in cases of thrombophilia, they help prevent the formation of clots and protect the placental circulation;
- Immunomodulatory therapies: In some situations, lipid infusions may be used to reduce excessive NK cell activity.
Monitoring is usually continuous throughout pregnancy and, in some cases, also after delivery, to reduce risks such as thrombosis.
What about male fertility?
The investigation should not be limited to women. It is estimated that approximately 30% of cases of recurrent miscarriage are linked to male factors. An increasingly relevant test is the sperm DNA fragmentation index, which assesses the genetic integrity of sperm and can directly influence embryo viability.
Information as an ally in the dream of getting pregnant
Immune infertility can be scary at first glance, but it is far from the end. Thanks to careful diagnosis, appropriate examinations and personalized treatments, many couples manage to overcome this obstacle and realize their desire to have a child. Seeking quality information and specialist support turns uncertainty into possibility – and strengthens the path to motherhood and fatherhood.
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