So, this is another hard post for me to write for you. I know that many of you are struggling right now with multiple miscarriages, infertility issues, and/or birth abnormalities in some of your children. All of these have been linked to autoimmune disease.
The fact is, there have been a number of studies that have shown a link between certain autoimmune diseases and an increased risk of miscarriage and chromosomal abnormalities. According to The Center for Human Reproduction, autoimmune disease can affect fertility and miscarriage risk. This study showed that the autoimmune disease itself can cause genetic abnormalities in the embryo. It is these abnormalities that ultimately lead to the miscarriage.
A true pioneer in the field of reproductive medicine, Dr. Alan Beer, estimated that up to 80% of infertility issues are caused by autoimmune diseases such as Lupus, Crohn’s, Rheumatoid Arthritis, chronic fatigue, allergies and thyroid disease. Very often, in women with impaired immunity, the body will perceive an embryo as a foreign object or as cancer cells. When this happens, natural killer cells in the uterus, go into overdrive and attack the embryo. The embryo is then rejected by the woman’s body.
There does seem to be a belief that some autoimmune diseases pose more of a threat to fertility or pregnancy loss, where others pose very little threat at all. Lupus has been identified as having a very high level of risk to both difficulty conceiving and recurrent miscarriage. Thyroid disease creates a higher risk of giving birth to children with birth defects, according to research presented at the 2001 Society for Maternal-Fetal Medicine’s annual meeting.
Other studies have shown that a woman with an autoimmune disease can even have infertility issues because her body continually attacks sperm that has entered the body and/or eggs as they leave the ovaries. This can make getting pregnant difficult.
Okay, so now we have the science behind us. Why then are so many women still suffering? Because a great number of doctors A) don’t know what they’re looking for, B) never look for the cause of the infertility/miscarriage, C) don’t believe the science behind the studies.
As some of you may know, if you’ve read my post on Traumatic Stress and Autoimmune Disease, I experience a pregnancy loss in my fourth month, back in 2002. Back then, my doctor did no research into what had caused the loss. The autopsy revealed a chromosomal trisomy defect. It was just explained to me that “that sort of thing just happens sometimes”. There were no questions asked as to how hard it had been for me to get pregnant. In fact, I had been in her office for years, complaining about heavy bleeding, clotting, and pain during my period. Each time, because my pap came back negative, I was told to simply take some baby aspirin and Tylenol.
I went years without getting pregnant. We tried a few procedures that never worked for us. And, all those years, I suffered every time my period came around.
Flash forward to last year when I ended up in urgent care with unexpected bleeding and pain. The two doctors I saw that night diagnosed a miscarriage. Further testing revealed the addition of endometriosis and a fibroid tumor. Luckily, one of those doctors was the same one who had finally diagnosed me with lupus. She suspected, due to the amount of scarring in my uterus, I had, over the years, experienced several miscarriages. She also believed it was possible that my body had attacked my own eggs as they left the ovaries, which had caused the pain I felt after ovulation. This had indeed impaired my ability to get pregnant over the last thirteen years. My biggest problem, I was 44 years old. I had already given up on having a child of my own. If only my doctors years ago had figured this all out. There was no way I would take a chance and try again now. It was too late for me.
But, don’t cry for me. I adopted this cute little dog named Giddy. She is my baby; and, I’m happy with that. Although sometimes I wish things were different, I accept them the way they are. I have finally found peace with it all.
What I think you should do if you have an autoimmune disease and are trying to get pregnant or have experienced pregnancy loss.
1. Work with a doctor who knows about autoimmune disease and pregnancy. With the proper care, many women can experience a successful pregnancy.
2. See a rheumatologist. These doctors understand autoimmune disease and can work with your doctor to fill in the gaps.
3. Don’t wait until it’s too late. Seek early treatment for all miscarriages and infertility issues. Keep searching until you can find a doctor who looks for the cause of your issues. Don’t assume they know what they’re doing.
4. Ask lots of questions. Why do I keep having miscarriages? If I get pregnant, how can I ensure my body doesn’t attack the embryo? What is the possibility that my baby will be born with an abnormality?
5. Give your doctor details. Be sure to let them know you have an autoimmune disease. Tell them the date of your last flare. Make sure you give them all of the information they’re going to need to formulate a plan of action specific to you. It’s best not to try to get pregnant while you are experiencing a flare.
6. Discuss lowering dosage or stopping medications, such as steroids, while trying to get pregnant and during the first trimester.
7. If you’re taking fertility drugs, tell your doctor about any symptoms you may experience. It has been proven that these drugs can provoke a flare in some women with autoimmune disease.
8. Talk to your doctor about testing for antinuclear antibodies and antiphospholipid syndrome. Women with antinuclear antibodies also have less success with IVF. Women with antiphospholipid syndrome have a problem with blood clotting. Most miscarriages are caused by improper blood clotting. Usually, a low dose aspirin is prescribed.
9. Do your research. I have listed some great internet resources below. Take your knowledge into your own hands.
10.Don’t give up. Although I gave up on having a human child, I have a beautiful furry baby that I love with all my heart. And, there are always surrogates and adoptees to consider. You need to do what is best for you. Sometimes, it’s different than what we want; but sometimes, it’s what we need. There are many children (and animals) out there who need a loving family to care for them. Maybe, that’s the role you were meant to play.
I would love to hear your stories, your successes and your struggles. Know that you are not alone. If we can inspire and comfort each other, our struggles can make us stronger. As a community, we can all help one another.
Bless you all.