Friday, August 22

Auto-immune & Blood Clotting Disorders Contributing to Infertility & Recurrent Miscarriage

We  have 30 different types of white blood cells as part of our immune system. In a reproductive immunophenoptype panel, eight of the most important ones are tested.

Disorders in any of these eight are prognosticators for a future pregnancy loss regardless of how the conception was achieved.

Listed below are an explanation of some of these cells, representative tests and their significance.

  1. CD-3 cells. Normal range: 63 - 86%
These are the most important cells in the immune system. They are low when the immune system is poorly functioning (suppressed) and normal when the immune function is normal. Infertile patients and those with repeated pregnancy loss have values in the high normal range. These individuals have immune systems that are very strong or overactive. An overactive immune function is frequently associated with a 5% incidence of autoimmune disease including but not limited to thyroiditis, lupus, and rheumatoid arthritis.

  1. CD-4 (T – helper cells). Normal range:  31 – 53%
These cells direct the action of other lymphocytes.  In women with infertility or  miscarriage these cells are high because they are helping CD3 cells.

  1. CD – 8 (T – cytotoxic suppressors). Normal range: 17-35%
These cells coordinate how strongly or how weakly the immune system reacts. They are like referees.  In women with repeated miscarriage or infertility, these cells are frequently low as they become exhausted negotiating the hyperactive CD – 3 cells and CD – 4 helper cells.

  1. CD -19 (B cells). Normal range: 3-8%
These cells are plasma cells (white blood cells called B cells that have been triggered to make antibodies). IgM is the first antibody produced to fight anything that enters our body that shouldn’t.   This antibody stays in the blood and then, as the immune response progresses it produces IgG (gamma globulin G) and resides in the lymph system.  IgA, (gamma globulin A), is the last antibody made in an immune response. It resides in and protects the organs, skin and GI tract. When this antibody appears, it means that the immune response is completed and cannot go any further.

When IgA responses (organ immunity) are present in any test for reproductive failure it usually means that the patient has an autoimmune process such as lupus, rheumatoid arthritis or other disorders.

CD- 19 B cells are almost always high-normal or very elevated in women with an immune cause for their infertility or recurrent pregnancy loss.  There is frequently a greater than 12% elevation. This is a very important indicator that the immune system is being over-worked. Endometriosis also provokes CD -19 activity.

Immune and/or blood clotting pathologies are responsible for approximately 30% of repeated pregnancy loss.

Antiphospholipid antibodies
Antiphospholipid antibodies (APA) have been linked to poor reproductive performance including infertility and repeated pregnancy loss. The typical treatment for this disorder is heparin or lovenox and baby aspirin.

Aspirin prevents intravascular thrombosis (blood clotting) from occurring in the early utero-placental vasculature. There are many herbs including but not limited to *dan shen, chuan xiong, tao ren, yi mu cao, hong hua and wang bu liu xing which do the same thing that aspirin does in the APA+ patient. The difference however, is that the herbs in combination with acupuncture do not cause stomach problems or bleeding problems or ulcers. Additionally, herbs are given in formulas which usually address both the cause and the manifestation of a pathology whereas aspirin treats only the manifestation.

I am not suggesting that you do not take aspirin if it is recommended by your reproductive endocrinologist; only that you consider getting treated with acupuncture and herbs simultaneously as this type of therapy is synergistic, complementary, and potentiating of the Western regimen.

Acupuncture and herbal medicine have been used for immunoregulation and blood clotting causes of infertility and/or repeated pregnancy loss for millennia. 

My clinical experience has shown that when combining acupuncture and herbs with the appropriate immunosuppressants such as dexamethasone or IVIG the effect is more pronounced then when using one of these therapies alone.  We have seen, for example, many patients who underwent immunosuppressive and/or anticoagulant therapy whereupon pregnancy was not achieved or, pregnancy was attained only to end in miscarriage. Subsequent cycles which included acupuncture and herbs resulted in increased numbers of take-home baby’s. Obviously this is not the case with each and every cycle but we have seen success enough times with the inclusion of acupuncture and herbs where success was not previously manifest that experientially we can conclude that the inclusion of acupuncture and herbs significantly improves the desired outcome.

A combined approach is recommended because Western immunosuppressive therapies though efficacious, treat the manifestation of the problem and not the underlying cause which means that your chances of conceiving this time will improve but once you stop taking the medicine, the effects will cease. Acupuncture and herbs strive to reach deeply into ones system and strongly alter the causation or etiology of infertility and repeated pregnancy loss; for good.

Acupuncture and herbs function to enhance and regulate the immune function and, offers a longer term solution. Drug therapies such as dexamethasone, prednisone and IVIG (intravenous immunoglobulin therapy) are much stronger than acupuncture and herbs and therefore,  have a more immediate effect. But acupuncture and herbs have a gentle, constant and longer term effect. Therefore, combining both therapeutic models will serve to 1) alleviate the immediate cause of infertility and/or repeated pregnancy loss and 2) strengthen and regulate the immune system to make you stronger and help balance and normalize your immune function so that you can increase your future fertility potential.

Natural Killer Cell Activity (cytotoxicity)
NK cells are lymphocytes that are present in endometrium and in the decidua during pregnancy.

Women with recurrent pregnancy loss, endometriosis and primary autoimmune conditions (such as rheumatoid arthritis and systemic lupus erythematosis), have been found to demonstrate elevated levels of NK cells, resulting in failed implantation.

Immunoglobulin (IVIG) has an ability to down-regulate and deactivate NKa cells.  Though IVIG has been shown to be effective, its effect is manifest only during the treatment and for a short period of time thereafter.  Including acupuncture and herbs in the treatment protocol not only enhances the effect of immunomodulation but, by regulating the immune response, has been shown to have longer lasting effect.  While it is true that we have not conducted formal studies on the effect of acupuncture and herbs in the suppression of NK activation, we can report success based on clinical experience.

Certain acupuncture points such as Stomach 36, Spleen 6, Ren17, and Ren 6, along with certain herbs including but not limited to *huang qi, shan yao, bai zhu, shu di, dang gui and lu rong have been used to successfully complement IVIG therapy via their immunoregulatory activity.

 The Berkley Center for Reproductive Wellness is the first complementary medicine clinic in the United States that specializes in treating reproductive disorders.  All of our practitioners are licensed and board certified. 

We have been treating fertility challenges in New York City since 1996. We have offices in Manhattan, Westchester and Long Island.

Our staff consists of specialists in acupuncture, herbal medicine, nutrition, yoga, Maya abdominal massage, mind-body-meditation, hypnotherapy and clinical counseling.

We treat patients from many reproductive medicine clinics including:

NY Weill Cornell
Saint Barnabas
Long Island IVF
Center for Reproductive Medicine and Infertility (CRMI)
Connecticut Fertility Associates
Kofinas Fertility Institute
Cooper Center for IVF
Sher Institute for Reproductive Medicine
And others…

Please feel free to call with your questions or enjoy a free 15 minute mini-consultation with any of our practitioners. 

By the way, we are the only clinic that offers a Full Refund program. Ask about it when you call!


*These herbs and acupuncture points are listed for illustrative purposes and I strongly recommend that you do not self medicate. Take herbs only when prescribed by a Board certified herbalist and one who specializes in treating infertility.

1 comment:

  1. I didn't even know this was possible. All my best friend wants in life is to become a mother. She's been trying for a while now to get pregnant, but has seen no success. I will have to tell her about this and maybe this will work for her.