Thursday, March 8, 2018

Recurrent Miscarriages: Is Your Immune System To Blame

By Dr. Beata Skorka, ND

Sadly, 15-20% of human pregnancies end in clinically recognized miscarriages, with the majority of them occurring within the first trimester. Reasons for recurrent miscarriages can vary, but include: parental genetic disorders, infectious diseases, endocrine dysfunctions, autoimmune disorders and uterine anatomical malformations.

Many couples trying to start or grow their family experience the painful and devastating end of a pregnancy, with some experiencing it multiple times. A miscarriage is recognized as a loss of a baby before 24 weeks of gestation. Recurrent miscarriage is seen as having had three or more consecutive miscarriages.  Below I will discuss one of the reasons for which miscarriages can occur- autoimmune and abnormal immunological responses.

Immune Conditions that Impact Fertility

When we think of our immune system, we often recognize it as a beneficial system in our body's that protects us from foreign invasion. However, our bodies ability to recognize what is self from non-self can either help or hurt us.  When functioning optimally, our immune system is protective. Problems arise when it sees parts of our bodies as non-self or foreign and attacks.

A woman's body must be able to recognize what is going on within itself and nurture the growing fetus.  Pregnancy is threatened when the body sees the placenta, uterus, fetus or blood as foreign and attacks, creating problems with fertility and/or miscarriage.

  • Antiphospholipid Syndrome (APS):  This condition in which the body makes high concentrations of antiphospholipid antibodies (APAs) in the blood, can increase the chance of blood clots. Antibodies are protective proteins made by the immune system in response to a 'foreign' substance. Multiple miscarriages can be the result of having this syndrome.  They are associated with both early and late fetal loss miscarriages, pre-eclampsia and poor growth of the fetus.  If recognized, treatment can significantly decrease the risk of miscarriage anywhere from 40-70% vs 10% if left untreated.
  • Anti-Nuclear Antibodies (ANA):  These antibodies are related to females suffering from autoimmune conditions such as Systemic Lupus Erythematous (SLE) and/or Rheumatoid Arthritis (RA), but can also be found in healthy individuals.  ANAs attack the cells of the uterus and the placenta, leading to inflammation which can affect implantation and cause early miscarriage.
    • SLE:  This is a chronic inflammatory autoimmune condition in which the immune system attacks healthy tissues.  Some symptoms to look out for include: butterfly-shaped rash across the cheeks and nose; raised red patches on the skin known as discoid rash; photosensitivity to sunlight resulting in rash; mouth and nose ulcers which are typically painless; arthritis; blood disorders; too much protein in the urine; disorders of the nervous system; heart and lung disorders.
    • Rheumatoid Arthritis (RA): An autoimmune condition that affects the joints, causing swelling, stiffness and pain.
  • Autoimmune Thyroiditis:  Thyroid antibodies can be present and affect a woman's ability to conceive and carry a baby.  Autoimmune thyroiditis can lead to either hypo or hyperthyroidism.  Alongside the thyroid, gluten reactivity needs to be addressed.  Celiac disease (immune reaction to gluten) is closely associated with autoimmunity and can be a compounding component of fertility.  Undiagnosed Celiac disease can lead to severe nutritional deficiencies that can cause infertility, recurrent miscarriage, stillbirths, poor growth of the fetus and unexplained infertility.
  • Natural Killer (NK) Cells:  NK cells are a type of white blood cell that acts as the immune system's first line of defence against infections and life threatening diseases such as cancer.  They are the main type of immune cell found in the uterus.  During pregnancy, they increase in number in order to facilitate the development of the placenta.  However, too much NK cells can be toxic and lead to fetal cell death and miscarriage.

Naturopathic Approach to Recurrent Miscarriages

Autoimmune conditions are just one cause of recurrent miscarriage and infertility.  We are all unique in our health, genetics and lifestyle and, therefore, our health needs to be addressed in this way.  A thorough assessment and treatment is vital to a woman's and man's fertility outcome.  A naturopathic workup would likely include:
  • Thorough current and past health history
  • Food intolerance testing and dietary monitoring
  • Antibody testing
  • Standard blood tests for fertility (thyroid levels, inflammatory markers, hormone levels etc.)
  • Standard and naturopathic physical exams

Naturopathic Treatment Options to Fertility Success

As a naturopathic doctor, I address the physical, emotional and structural issues associated with fertility. To complement diet and lifestyle recommendations, the following are often beneficial when working to optimize fertility:
Everyone's journey to starting a family is different.  Sometimes a little extra support is needed.  In subsequent blogs, I will explain the health benefits of the treatments listed above.

If you or someone you know is having difficulty conceiving, has unexplained infertility or has experienced the devastating loss of losing a baby and would like to book an appointment with Dr. Beata Skorka ND, please call Naturopathic Foundations Health Clinic at (905) 940-2727. 

Dr. Beata Skorka, ND is a licensed Naturopathic Doctor practising in Ontario.  She has an interest in fertility and is certified in Intravenous Therapy, which she utilizes in practice.