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Immune Treatments

Immune treatments revolve around herbal combinations or drugs that adjust either the suppressive or aggressive side of the immune system to improve fertility and health. For a successful pregnancy, both sides of the immune system must recognise and react to the arrival of “foreign” cells in the womb. Significant issues are inevitable if either the aggressive or suppressive sides have abnormal responses to pregnancy. Understanding how the immune system copes with the challenge of pregnancy is useful, and the various conditions we know about are in Immune Conditions.

There are main challenges with distinct responses:

  • An overly aggressive TH1 response
  • A lack of aggressive TH1 response
  • A lack of suppressive TH2 response

Immune dysfunction can play a part in premature ovarian failure, thyroid conditions, endometriosis and blocked tubes, and there are specific immune conditions that reduce fertility. The testing for these usually involves blood samples which can be expensive and difficult to access, and an endometrial biopsy is needed for some elevated NK cells. Treatment options range from immune-modulating herbal formulas to blood thinners and immune-suppressing medications.

Herbal treatments

Herbal treatments to regulate the immune system are helpful in many instances and need to be taken for three months. The success rates quoted relate to normalisation of immune status, for NOT pregnancy rates after treatment. The data for herbal prescriptions are based on clinical work by Dr Trevor Wing of The Women’s Natural Health Clinic, in collaboration with Martin Powell of MycoNutri.

Condition Prescription FCG Dose Success rate
Antinuclear antibodies (ANA) Immune formula # 1 4.5g a day 73% (69 patients)
Antiphospholipid antibodies (APA) APA formula 5-15g a day 81% (103 patients)
Anti-sperm antibodies (ASAb) Immune formula # 1 4.5g a day 86% (38 patients)
Human leukocyte antigens (HLA) None available
Anti-Leukocyte antibodies (LA) Immune formula # 2 9-15g a day 88% (59 patients)
Elevated Natural Killer (NK) cells Immune formula # 1 4.5g a day 96% (277 patients)
Anti-ovarian antibodies (OA) Immune formula # 1 4.5g a day 40% (67 patients)

Conventional treatments 

Specialist immune fertility clinics are found around the world, and much of the research is based on work done at the Alan Beer Institute in the USA.  The HFEA in the UK lists all immune suppressing options as unsafe and a risk to health, with a significant chance of developing allergic reactions and infections without evidence of greater success.

A review of immunotherapy in IVF found no evidence of better live birth rates or the prevention of recurrent pregnancy loss. The conclusion is immunotherapy should be used in research settings but not in routine clinical practice to improve reproductive outcomes. i The conventional treatment options for fertility-related immune conditions are:

Anti-Nuclear Antibodies

Conventional treatment for Anti-Nuclear Antibodies relies on immune-suppressing interventions. These include IVIg (currently banned in the USA), intralipids, adalimumab (Humira) and steroids (dexamethasone or prednisolone) + calcium.

Anti-Phospholipid Antibodies

Conventional treatment for Anti-Phospholipid Antibodies is with:

  1. Aspirin
  2. Aspirin plus blood-thinning drugs such as enoxaparin (Clexane), heparin, Fragmin or warfarin

Anti-Sperm Antibodies

Conventional treatment for Anti-Sperm Antibodies involves immune-suppressing interventions such as IVIg (currently banned in the USA), intralipids, adalimumab (Humira) and steroids (dexamethasone or prednisolone) + calcium.

HLA-DQα incompatibility

Unfortunately, there’s no effective treatment for the couple except the use of a donor egg or sperm.

Anti-Leukocyte antibodies

The standard treatment for anti- Leukocyte antibodies is leukocyte Immunisation Therapy (LIT) which involves immunising the woman with lymphocytes from the male partner or a donor. Some research shows an increased immune response with LIT use, and women who have repeated unexplained pregnancy loss also have low immune responses to LIT.

Elevated Natural Killer cells

The current conventional treatment for raised NK cells is to suppress the immune system with interventions such as IVIg, intralipids, adalimumab (Humira) and steroids (dexamethasone or prednisolone) + calcium.

Anti-Ovarian Antibodies

The current conventional treatment for anti-ovarian antibodies is steroids (dexamethasone or prednisolone) plus calcium.


Reference
i Achilli C, Duran-Retamal M, Saab W, Serhal P, Seshadri S. The role of immunotherapy in in vitro fertilization and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril. 2018 Nov;110(6):1089-1100. doi: 10.1016/j.fertnstert.2018.07.004. PMID: 30396553.
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