Immune Rejection as a Cause of Miscarriage or Implantation Failure

Jul 02 2012

At some point in our lives, we have all tricked our mothers.

We are not referring to the white lies of our youth or our schoolyard antics. We are talking about the critical moment in our lives: when we were embryos.

Due to the fact that the embryo does not have the same proteins or make up as maternal tissue, it is a unique moment for the mother’s immune system.

Because of this, in order to implant and develop in the mother’s uterus the phenomenon of immunotolerance must be set off and continue from the earliest staged of gestation. This makes the immune system, which is in charge of fighting and rejecting any foreign substance or tissue, accept the embryo.

Despite recent advances in this field, we still do not know exactly how the embryo silences the maternal immune system. We do know that autoimmune disorders and the presence of antibodies in the mother’s blood cause implantation failure, repeat miscarriages, delayed foetal growth, placental insufficiency and intrauterine foetal demise.

Therefore these situations require us to rule out these possibilities.

Nowadays there are many useful treatments. The use of heparin, aspirin and in some cases corticosteroids from the beginning of the gestation until the end has shown to be very helpful in the prevention and the treatment of these conditions.

On the other hand a very controversial question is what to do when a woman suffers from implantation failure after a number of IVF attempts, where everything appears normal, good quality embryos, and nevertheless they do not implant or they end in an early miscarriage. Furthermore the studies carried out do not show any known causes.

Also when a women suffers from repeat miscarriages due to unknown causes.

What do we do when we suspect but cannot confirm that an immune rejection exists?

In the Instituto Bernabeu Implantation Failure Unit, and in collaboration with immune experts from England and Germany, we have developed different personalised treatment protocols.  These includes such varied medications as hydroxycloroquine, metformin, intravenous intralipids, heparin, granulocyte colony stimulating factor, vitamin D (which acts as a hormone), polysaturated fatty acids, etc., which act as immunomodulators and improve the possibilities of correct implantation and development of the pregnancy throughout the whole nine months.

Even if we have not fully answered the question of why do my embryos not implant, or why do I miscarry, we have been able to successfully treat and solve this distressing problem with the help of these new protocols.

Dr. Rafael Bernabeu, Medical Director of Instituto Bernabeu.

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