Natural treatments for autoimmune infertility

Here is my article on naturopathic treatments for autoimmune infertility which was published in the March 2011 NDNR Journal. Infertility is a reproductive disease which has an enormous impact on the quality of life for millions of patients. It is known that autoimmune diseases such as diabetes, autoimmune thyroiditis and systemic lupus erythematosis are linked to decreased fertility. Endometriosis has many autoimmune components including elevated levels of cytokines, and T- and B-cell abnormalities.
Thyroid diseases involving antithyroid antibodies have been correlated to infertility and increased pregnancy loss. Antinuclear antibodies (ANAs ) which have been associated with infertility can be present in conditions such as SLE, Sjogren’s syndrome, Raynaud’s syndrome, and can also be detected in women with a history of exposure to chemicals such as bisphenol-A. Patients with celiac disease may have multiple nutritional deficiencies that can lead to infertility. In approximately 20% of women with premature ovarian insufficiency(POI), autoimmune factors can be found. Elevated peripheral NK cells are associated with many systemic autoimmune diseases but can also be found in women with unexplained infertility conditions.
Both folate deficiency and hyperhomocysteinemia are known to be risk factors for infertility and pregnancy complications.
There are important laboratory tests that should be completed for patients who have immunological issues along with fertility concerns. Some of the following treatment options may be considered after a thorough assessment determines specific autoimmune factors. Thyroid protomorphogen may be useful for patients with antithyroid antibodies to act as a decoy. Elimination of gluten should be implemented as required for patients with positive serology.
As a Toronto naturopath who focuses primarily on the treatment of infertility, I see so many cases where autoimmunity influences reproduction. It affects 1 in 5 of all couples, and most patients undergo extensive diagnostic and treatment interventions on their journey to create a family.
Other causes of infertility such as premature ovarian insufficiency, endometriosis and polycystic ovarian syndrome include autoimmune components.
Like classical autoimmune diseases, endometriosis has been associated with polyclonal B-cell activation, immunological abnormalities in T- and B-cell functions, increased apoptosis, tissue damage, multiorgan involvement, familial occurrence, possible genetic basis, involvement of environmental cofactors, and association with other autoimmune diseases.
The same study found increased levels of these antibodies in patients with a list of other autoimmune conditions. Autoimmune thyroid disease, even in the absence of hypothyroidism has been associated with infertility and reduced response to fertility treatment. Celiac disease has been linked to recurrent miscarriage, pregnancy complication and infertility.
POI can be linked to autoimmune thyroid disease, Addison’s disease, or SLE or may have unknown etiology.
Errors in these pathways caused by genetic mutations have been associated with autoimmune diseases Patients with a mutation of the MTHFR gene have difficulty reducing 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate. It has also been found to be beneficial in the treatment of autoimmune disease,, and to reduce NK cell activity. Autoimmune diseases are aggravated by stress as it can increase humoral immunity and shift TH1:TH2 ratios. Thyroid Autoimmunity and its Association with Cellular and Humoral Immunity in Women with Reproductive Failures. Elevated antithyroid peroxidase antibodies indicating Hashimoto’s thyroiditis are associated with the treatment response in infertile women with polycystic ovary syndrome.

Prevalence of coeliac disease in patients with autoimmune thyroiditis in a Turkish population.
Natural Killer Cells in Pregnancy and Recurrent Pregnancy Loss: Endocrine and Immunologic Perspectives.
Effects of oral consumption of the green tea polyphenol EGCG in a murine model for human Sjogren’s syndrome, an autoimmune disease.
Effect of resveratrol, a natural polyphenolic compound, on platelet activation induced by endotoxin or thrombin. N-acetyl-L-cysteine ameliorates the  inflammatory disease process in experimental autoimmune encephalomyelitis in Lewis rats.
Selenium supplementation in autoimmune thyroiditis female patient–effects on thyroid and ovarian functions (case study). Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. Infertility has a myriad of causes including endocrine disorders, gynecological disease, infectious disease, circulatory disease and aging and cellular health. In many unexplained cases of infertility, inflammatory processes may be involved or antibodies may be directed against hormones, clotting factors, or reproductive tissues such as the ovaries or testes.
A 2010 study found that between 5-10% of women with a history of stillbirth, recurrent miscarriage, intrauterine growth restriction, and infertility were seropositive for transglutaminase IgA compared to 1% of the control group.
Improves autoimmune thyroid disease NAC also enhances semen parameters and the oxidative status and quality of the endometrium . Autoimmune disorders are also implicated in reproductive disorders and may especially play a role in unexplained cases of infertility. Autoimmune thyroid disease can lead to hypo or hyperthyroidism which can impact fertility and cause miscarriage. A 2010 study on a group of 71 Swedish and Finnish female patients with unexplained infertility found a higher incidence of folate metabolism polymorphisms compared to women in the general population.
Because of the side effects of heparin therapy, it is not chosen as the first course of action in treating immunologic infertility.
Intravenous immunoglobulin treatments are used by some physicians to treat severe autoimmunity, and steroids like prednisone are also used to suppress overactive immune systems.In ancient Chinese literature, a combination of the herbs Dang Gui (Angelica) and Chuan Xiong (Ligusticum Wallichii) , were given to women whose periods were late, to either help bring on the menses if she wasn't pregnant. These signs and symptoms might include uterine cramping, a history of dark, clotty menstrual flow, and a pulse whose quality is not smooth, and whose strength seems to come and go in either one or both wrists around the time of implantation and into early pregnancy.Serotonin is one of the chemicals involved in preparing the uterus for pregnancy. Modern Reproductive Endocrinology has only recognized the impact of immunologic factors for a few years.
As with all Chinese Medical treatment, a proper diagnostic pattern must be established before treatment will be effective. There may also be no clinical symptoms except for a sticky, thick vaginal discharge and positive sperm (blood essence) antibodies. PABA effects the formation of red blood cells, protein metabolism and stimulates the production of folic acid in the intestines. Another negative consequence of overuse of antibiotics, glucocorticoids, and birth control pill brings us to our next topic, that of yeast syndrome.YeastMany patients are over prescribed antibiotics for conditions which may not warrant their use, but we have come to rely on them as a treatment for many conditions. Antibiotics are often prescribed for respiratory and stomach viruses, on which they have no effect.
When these symptoms subside, the symptoms caused by yeast overgrowth should be alleviated.Claudia's OrdealClaudia and her husband Jerome, both age 37, had been married for four years.
Unfortunately, Jerome's sperm analysis revealed an overall low sperm count, marginal motility, and very poor morphology (88% abnormal forms.) He was diagnosed with a slight varicocele.
She had previously undergone a full fertility workup, laparoscopy, six unsuccessful Clomid cycles, three hormonally stimulated intrauterine inseminations, and one failed IVF treatment.
They were tired, frustrated and frantic for answers.Claudia and Jerome scheduled separate appointments and I treated each of them weekly.

I gave him a list of supplements to purchase (Vitamins A, C, E, selenium, zinc, L-Arginine and L-Carnitine), and I treated him for his headaches, which were caused by stress manifesting as liver depression, qi stagnation with depressive heat. He dealt with his stress, was treated for his headaches, and he quit taking his ibuprofin and ambien. She had already eliminated caffeine and alcohol, and ate a fairly healthy diet, except for her monthly menstrual coke. Her pulse was full and taut, like a vibrating metal guitar string.I prescribed two herbal formulas, one during the follicular phase to tonify the yang aspect of her kidney and clear damp-heat, and a luteal phase formula to clear the liver, rectify the qi and invigorate the blood.
She still had not conceived, however.In their desparation, the couple sought out another reproductive endocrinologist for further treatment. Both Claudia and Jerome were found to carry and exchange a bacterial infection called ureoplasma, which was blamed as the culprit for implantation failure. They were jointly prescribed antibiotics for one month, after which another hormonally stimulated insemination was performed.
We discussed the potential immunologic nature of her implantation failure, and I prescribed the formula (above) to clear damp heat, and modified with liver rectifying herbs like bupleurum. The floaters went away.Meanwhile, however, the clock was still ticking, and Jerome and Claudia, now 38, decided to go out of state for reproductive immunologic treatments. Claudia received a more complete laboratory analysis of immunologic factors, and started treatment for another IVF.
At least hopeful that her uterus had allowed implantation, they geared up for another cycle. Her body, thinking these invaders were harmful, were rejecting their embryos.The PMS and depression had returned, now in the form of despair. One last modification to the herbal formula, incorporating treatments for liver blood vacuity, liver qi stagnation, and damp heat, threw Claudia's body into balance within weeks.She never had another period. Just before she came to see me her FSH was 98 and she was given a prescription for hormone replacement therapy.Laura's hands were ice cold. I knew she would respond better to herbal therapy, and saw her in the clinic every two weeks for herbal modification. I prescribed a formula consisting of Concha Ostrea, Radix Astragali Membranacei, Radix Ephedrae, Semen Tritici Aestivi Levis, and Radix Rehmanniae Glutinosae. She came for acupuncture treatments every week throughout the first trimester, and then returned only for assistance in preparing for labor. These are the women who receive dismal results from their western medical caregivers.The most common reason for early pregnancy loss is the same as luteal phase defect - inadequate progesterone production. Each time the story was the same: she missed her period, went in to the clinic for blood tests to assess beta-hCG and progesterone levels, which were adequate and rising as they should.
I switched the focus of the acupuncture treatments to resolving blood stasis in the uterus and rectifying the qi.
I advised her to come in for treatments at least three times per week, and drink the herbal tea three times per day, more if the contractions returned. She told me she had very little money, so we agreed on a lesser payment as she could afford for one weekly treatment, but I would still see her as often as was necessary.
She carried her son to eight and a half months, and gave birth at home.The herbal formula I prescribed for Christine is often used to treat endometriosis and uterine fibroids, and other manifestations of uterine blood stasis. Although she did not have a history of these conditions, her treatment was based solely upon her pattern presentation.

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