Pregnancy and immunity: what is the implication in implantation failures and miscarriages?

Pregnancy is an exceptional immune situation. It is the only immune exception: during this period, our immunity tolerates the presence and especially the development of a foreign body! And for that, great adaptations are necessary.

Indeed, during the first 3 months of pregnancy, powerful immune changes take place. If they are successful, they will lead to the acceptance of the embryo^[1].

As you can imagine, if they cannot take place in the right way, there is a great risk of hindering a successful pregnancy with implantation defects and miscarriages. These first 3 months are also considered "fragile" since this lack of immune balance can lead to the pregnancy termination.

What are the immune changes that are essential for embryo acceptance?

The immune changes

Among these changes, some relate to innate immunity (the first line of immune attack). For example, as soon as the hormone HCG enters the bloodstream and the embryo is attached to the endometrium through the trophoblast (premise of the placenta), the natural killer, the first nonspecific immune defense cells (i.e. which attack all types of foreign bodies), are reduced by 70%. Thus, a climate of immune calm begins to set in to facilitate the implantation of the embryo.

Other modifications relate to specific immunity, ie lymphocytes. They're kind of immune hit killers. Each has its own specialty. In order to distinguish them, they are grouped under large branches. Among them, there are TH1 and TH2 branches, which respectively provide immune defense and tolerance functions. For example, for these two branches, the balance during pregnancy is completely reversed compared to their balance outside of pregnancy.

These two branches are balanced by a very specific type of lymphocytes, and very specific to pregnancy, the regulatory T lymphocytes.^[2]. These famous T reg are the most important protectors of the embryo, they can unfortunately be reduced in certain situations such as the presence of autoimmune diseases, allergies, atopy (eczema) or even chronic digestive disorders.

Numerous studies confirm it: immune balance and especially the adaptive capacity of immunity are essential for the acceptance of a pregnancy and its good progress.

These adaptations should be automatic, but we must understand that our environment, our diet and also our lifestyle are full of immune disruptors. One of the best known: stress.

Moreover, in situations of infertility, specialists begin to turn more and more to the hypothesis of a dysfunction of the immunity. But so far, the examinations performed and treatment proposals do not always seem appropriate to the situation.

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For example, on natural killer hyperimmunity, cortisone-based treatment may be offered, since cortisone causes immune suppression (decline). However, this treatment could have negative consequences on vascularity and stress levels.

It is important to be careful when trying to fix one problem, not to create another. The tendency of every organism is to seek a state of balance. The objective is therefore rather to help the body achieve this state as a whole rather than taking too targeted action, which may not solve the root of the problem.

Therefore, in the Fertil-In programs, we have made the immune balance a priority. On scientific bases, our algorithm questions scans your immune field. It provides you with the targeted and personalized solutions to make the immunity "tolerant" to the embryo.

Many actions are taken depending on the situation around immune disruptors such as gluten or histamine, but also modulators such as vitamin D^[3], Omega 3, intestinal flora, stress management or even coenzyme Q10^[4]. Depending on your profile and your suspicions of deficiencies, the algorithm offers you the tracks that are suitable for you.

Is it working?

Marie, Susanna, Manuella and many others will be able to say that, after implantation failures, repeated miscarriages and other unsuccessful treatments, they were able to lead to progressive pregnancies thanks to our programs!

See our Fertil-In programs

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Notes :

[1] Kayem, G., & Batteux, F. (2008). Immunologie de la grossesse. La Presse Médicale, 37(11), 1612‑1619. doi.org/10.1016/j.lpm.2008.07.006

[2] Melinda J. Jasper, Kelton P. Tremellen, Sarah A. Robertson, Primary unexplained infertility is associated with reduced expression of the T-regulatory cell transcription factor Foxp3 in endometrial tissue, Molecular Human Reproduction, Volume 12, Issue 5, May 2006, Pages 301–308, doi.org/10.1093/molehr/gal032

[3] Cantorna, M. T., Lin, Y. D., Arora, J., Bora, S., Tian, Y., Nichols, R. G., & Patterson, A. D. (2019). Vitamin D Regulates the Microbiota to Control the Numbers of RORγt/FoxP3+ Regulatory T Cells in the Colon. Frontiers in immunology, 10, 1772. doi.org/10.3389/fimmu.2019.01772

[4] Talukdar, A., Sharma, K. A., Rai, R., Deka, D., & Rao, D. N. (2015). Effect of Coenzyme Q10 on Th1/Th2 Paradigm in Females with Idiopathic Recurrent Pregnancy Loss. American journal of reproductive immunology (New York, N.Y. : 1989), 74(2), 169–180. doi.org/10.1111/aji.12376