Reproductive immunology and fertility

Fertility and pregnancy are complex processes involving numerous biological mechanisms. In addition to hormonal, genetic or anatomical factors, the immune system also plays an important role during the early stages of pregnancy. The immune system’s main function is to protect the body against infections and external agents. However, during pregnancy a very particular phenomenon must occur: the maternal body must develop tolerance mechanisms that allow embryo implantation and development.

This process involves a delicate immunological balance between mother and embryo, known as maternal-foetal dialogue. When certain clinical circumstances exist, such as repeated implantation failure or recurrent miscarriage, assessment in the field of reproductive immunology may be considered.

At Viamed Fertility Institute, we work in coordination with specialists to offer an individualised evaluation when the case requires it, always based on the available scientific evidence.

What is reproductive immunology?

Reproductive immunology is the medical field that studies the relationship between the immune system and human reproduction.

During pregnancy, the embryo contains genetic information from both the mother and the father. This means that, from an immunological point of view, the maternal body must adapt in order to allow its development without compromising normal defence mechanisms.

For pregnancy to progress correctly, an appropriate interaction must be established between:

The maternal immune system

The endometrium

Embryo implantation

Early placental development

The early development of pregnancy

Reproductive immunology analyses possible alterations in these mechanisms when specific clinical situations may justify a targeted assessment.

When may reproductive immunology assessment be recommended?

Immunological assessment is not part of the routine fertility study and not all patients need this type of evaluation. However, in certain specific cases, the medical team may consider it useful to broaden the study. Situations in which immunological assessment may be considered include:

Repeated embryo implantation failure

Recurrent miscarriage

Certain analytical alterations

Specific clinical history

Selected cases in which it is necessary to broaden the reproductive study

The indication must always be individualised and assessed jointly with the fertility specialist team.

Relationship between immunology and embryo implantation

Embryo implantation is a complex process that requires coordinated interaction between the embryo and the endometrium.

During this initial stage, biological mechanisms related to the following must be activated:

Endometrial receptivity

Vascular development

Inflammatory regulation

Immune tolerance mechanisms

Maternal-embryonic communication

In certain circumstances, alterations may exist in the immune response that could potentially interfere with this process.

The aim of reproductive immunology is to study these possible factors when there is a specific clinical indication, although this is a field in continuous scientific evolution and development.

Reproductive immunology and recurrent miscarriage

Recurrent miscarriage may be related to different factors and requires a comprehensive evaluation. Possible causes that are usually studied include:

Chromosomal alterations

Uterine anatomical factors

Endocrine alterations

Coagulation disorders

Immunological factors

When there is a history of recurrent pregnancy loss and the medical team considers it indicated, immunological assessment may form part of the multidisciplinary study. Each case must be approached individually in order to identify possible associated factors and define the most appropriate follow-up.

A field in constant research

Reproductive immunology is a discipline in continuous research and evolution. There is currently growing scientific interest in better understanding the relationship between the immune system, embryo implantation and early pregnancy development. However, the available evidence continues to evolve and many lines of research remain under development. For this reason, immunological assessment must always be carried out on an individual basis, avoiding generalisations and basing clinical decisions on current scientific evidence and on each patient’s characteristics.

A multidisciplinary approach in immunology and fertility

Fertility does not depend on a single factor. In some patients, hormonal, immunological, metabolic or male factors may coexist and require a joint assessment. For this reason, at Viamed Fertility Institute we work from a multidisciplinary and coordinated approach between assisted reproduction specialists and other medical areas. When there is a clinical indication, the study can be complemented by the involvement of specialised professionals to offer a comprehensive and personalised assessment. Our aim is to accompany the patient throughout the reproductive process and adapt the approach to the needs of each case.

Frequently asked questions about reproductive immunology

It analyses the relationship between the immune system and the processes involved in embryo implantation and early pregnancy development.

No. Immunological assessment is reserved for specific cases and does not form part of the routine fertility study.

The immune system participates in mechanisms related to implantation and early pregnancy development, although each situation must be assessed professionally and individually.

It may be considered in situations such as repeated implantation failure, recurrent miscarriage or certain analytical alterations.

It is a medical area in continuous research and development, so clinical decisions must always be based on the available scientific evidence and on each patient’s characteristics.

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Dr. Pamela Valdivieso Mejía

gynaecologist and specialist in assisted reproduction

Dr. Silvia Valladares Jiménez

Specialist in Endocrinology and Nutrition

Dr. José Vilar

GYNAECOLOGIST

Ángeles Bretón

CLINICAL EMBRYOLOGIST

Dr. Carlos Javier Vega Reina

GYNAECOLOGIST

Dr. María Miró

IMMUNOLOGIST

Dr. María Eugenia Molina

HEMATOLOGIST

Elena Mantrana Bermejo

Gynecologist. Specialist in Reproductive Medicine

  • Degree in Medicine and Surgery from the University of Seville.
  • Specialty in Obstetrics and Gynecology at Hospital Universitario de Valme, Seville.
  • Master’s Degree in Human Reproduction from the Universidad Rey Juan Carlos.
  • Specialist Physician of the Andalusian Health Service in the South Health Management Area (AGSS) of Seville.
  • Coordinator of the Assisted Human Reproduction Unit of the Hospital Universitario de Valme, Seville.
  • Member of the Human Reproduction Advisory Committee of AGSS of Seville.
  • Member of the working group for the update of the Guide for Assisted Human Reproduction of the Ministry of Health of the Andalusian Regional Government.
  • Tutor of Specialist Doctors in Training of the Teaching Area of the University Hospital of Valme.
  • Clinical Tutor Medical Students University of Seville

Alberto Armijo

Gynecologist. Reproductive Medicine Specialist