Like many women with lupus, Charlotta put aside her dream of becoming a mother indefinitely. Her doctor continually warned her to avoid getting pregnant. “For more than ten years I was such a mess - from my lupus and medication. I knew I wanted kids, it just hadn’t been on the agenda because it wasn’t allowed. Pregnancy was just a no-no,” she explains.
For women like Charlotta who suffer from autoimmune disease, pregnancy remains elusive. Aside from the medical warnings, a number of autoimmune conditions have been linked to infertility, including type 1 diabetes, celiac disease, thyroid disease and lupus. While some directly affect reproductive organs, making a clear connection between disease and infertility, other conditions cause unexplained or idiopathic infertility. In other words, there are no medical grounds as to why you can’t have a baby. The stork just hasn’t found its way to you yet.
A Closer Look at the AID - Infertility Connection
Let’s take a closer look at how some of the autoimmune conditions mentioned above can impact fertility.
- Diabetes Type 1 and Infertility: Insulin-dependent diabetes is a chronic condition where the body produces little or no insulin due to inflammation in the insulin-producing cells of the pancreas. One study found that women with type 1 diabetes may have longer cycles, longer periods, and heavier bleeding than women without the disease, three factors that make it difficult to achieve pregnancy.1
- Celiac Disease and Idiopathic Infertility: When a case of undiagnosed celiac resulted in two years of unexplained infertility, researchers found that screening for gluten intolerance in women with digestive symptoms who were unable to conceive could prove clinically-effective: a gluten-free diet can reverse this heartbreaking condition. In fact, many progressive fertility clinics require women, and in some cases their husbands, to avoid gluten for a number of weeks prior to undergoing invasive fertility testing.2
- Thyroid Disease and Unexplained Infertility. At Mymee, we see many women with diagnosed and undiagnosed thyroid disease with and without Hashimoto’s , an inflammatory condition of the thyroid gland. Among the most prevalent of autoimmune diseases, thyroid diseases affect between 2 - 5 % of the population. When left unaddressed, abnormal thyroid function with symptoms like being cold, weight gain, dry brittle nails and hair, as well as unexplained infertility, can present years prior to antibodies being discovered.
- A Harvard Medical School study revealed that nearly twice as many women with unexplained infertility had TSH levels of 2.5 mIU/L or higher, compared with a fertile control group.3 While this TSH level is considered within normal range, it may still silently tamper with a woman’s potential fertility. In addition, many environmental factors such as vitamin D and selenium deficiency, as well as radiation and iodine exposures are associated with Hashimoto’s. At Mymee, we help clients address potential environmental factors to reduce symptoms of thyroid disease.4
- Lupus and Unexplained Infertility. Lupus may not cause infertility, but it can certainly complicate things. As in Charlotta’s case, it’s recommended to wait until you’re in remission, or at least until your condition has been inactive for at least six months. “In working with Mymee my health immediately got better, and within a year my blood count was within normal range (within what can be expected with Lupus). It was very very good. That’s when my doctor actually said to me ‘Now you need to go get pregnant because you are not flaring and you’re in good shape!’ I was just in shock that it was suddenly possible for me.”
Can Medications Trigger or Cause Autoimmune Conditions?
It may seem counterintuitive, but studies continue to show that certain medications can trigger chronic conditions like lupus.
For example, the relationship between estrogen-based birth control, a known risk factor for immune impairment and ironically used to delay fertility, is well established. One study found that women were at the highest risk of developing lupus when they first started taking birth control pills; a second found the risk to be higher the longer a woman was on the pill; and yet a third study identified that any history of birth control pills is a risk factor.5
Unfortunately, women receiving treatment for thyroid conditions are also not out of the woods. Levothyroxine, the most commonly-prescribed medication for hypothyroid disease, was recently found to be a risk for drug-induced lupus, along with 100 additional drugs that may induce lupus.6 Likewise, some lupus treatments, such as a chemotherapy drug called methotrexate, can lead to infertility.7
PCOS, Endometriosis and Infertility
There are other known conditions that produce inflammation and are considered autoimmune-related. One of the most common - but treatable - causes of infertility in women is polycystic ovary syndrome (PCOS). PCOS is an inflammatory and autoimmune-related condition that is also mediated by lifestyle-sensitive hormones like excess insulin. Like diabetes, PCOS also affects cycle length and reliability of ovulation.8
Endometriosis is another common auto-immune-related condition that poses an infertility risk among young women. Defined as the presence of glands and stroma tissue outside the uterus, endometriosis induces a chronic inflammatory reaction, scar tissue, and adhesions that may cause problematic changes in a woman’s anatomy preventing implantation. It is diagnosed when women complain of pelvic pain, dysmenorrhea, and dyspareunia. Interestingly, up to 25% of women with endometriosis present without symptoms.9
Infertility: Never One Size Fits All
Infertility isn’t just a condition of the ovaries and uterus, and the reason for your infertility may be entirely different from someone else’s. In any case, fertility can either be supported by your health or shattered by underlying autoimmune conditions as well as lifestyle choices. Conditions that affect regular periods also make it tricky to understand if and when you’re ovulating. In some instances, you may benefit from education around your cycle to learn when the time is right to engage in sexual activity with your partner. In some cases tracking your cycle may help, while in other instances, fertility testing may be needed .
Defying the Odds
If you’re trying to get pregnant and suffer from autoimmunity, following these tips may help you defy the odds to increase your chance of success: :
- Find your triggers. Joining Mymee will help you parse out foods that are good for you versus those that may be contributing to your cycle irregularity, and ultimately, your infertility. Annie found that her love of pizza was kicking up her body pain, which led to irregular periods. Once she focused on her frequent takeout habit and made a few changes, her periods normalized.
- Get some sleep! Food is not the only type of trigger that may be affecting your health. Sleep is a crucial part of your day: this is when your body rests and repairs itself. Mymee was designed to help you identify any trigger so if sleep is proving to be a problem our coaches can identify it , just like they did for Joanna. Joanna loved having her long-haired cat sleep in her bed, but it was also forcing her to rely on allergy medication, which led to sleepless nights. Although she mourned the loss of her cat, working with her coach, Joanna realized that she was sleeping better and her cycles normalized.
- Rest and digest to improve your cycle: Activating certain aspects of your nervous system that regulate digestion and relaxation allows your body to better absorb nutrients from food, beverages and supplements, and generate enough energy for your body to heal. When the nervous system is regulated, blood sugar is easier to regulate, inflammation is reduced, and menstrual cycles return to normal. Mymee clients have even found that their medications work better, and in many cases, they can even discuss the possibility of reducing their meds with their doctor.
- Environment vs. genetics. Did you know that where you live or work can impact your health and fertility? Scientists at Stanford discovered that 77% of our immune response is driven by our environment rather than our DNA. Environment can include weather, air quality (inside and outside your home or office), and even the emotional tone of your home. Devin discovered that mold in her office was contributing to regular yeast infections and a lengthy PMS symptoms, making baby-making cumbersome and uncomfortable. Once her triggers were identified and she took steps to heal her body, Devin resumed sexual activity and became pregnant shortly after completing the Mymee program.
At Mymee, we focus on the underlying similarities between autoimmune diseases rather than on their differences.
Whether you have a diagnosis, or several autoimmune diseases, or none at all, Mymee clients may share a common underlying disease process. As a group, autoimmune diseases are triggered by genetic and environmental factors. They dysregulate the immune system and generate inflammation. They create a variety of unpredictable symptoms that deteriorate our health and affect our quality of life. This is why so many autoimmune warriors and the undiagnosed alike, share common consequences of inflammatory immune-dysregulation like infertility, as well as fatigue, stomach and digestive complaints, brain fog, muscle and joint pain, sleeplessness and anxiety.
As Charlotta explains, working with Mymee extended well beyond her ability to realize her dream of motherhood. “From the first year of working with Mymee, my health immediately improved. I had gotten off all medications - from a handful down to just one pill! That was so dramatic, and a huge change of worlds for me.”
If you’re thinking about getting pregnant and worried about overcoming the odds, talk to us. Mymee will tailor a program just for you, to identify and reduce any triggers that might be getting in the way, and work with you to make sure motherhood can be in your future plans.
References
- 10 Conditions That Could Be Messing With Your Period
- Unexplained infertility as primary presentation of celiac disease, a case report and literature review
- Underactive Thyroid Implicated in Unexplained Infertility -High-normal TSH common in women with the condition
- Autoimmunity: From Bench to Bedside: Thyroid disease and autoimmune disease
- The Possible Link Between Birth Control & Autoimmune Disease
- Drug-Induced Lupus now exceeds 100 possible culprits
- Women’s Health and Reproductive Issues with Lupus
- Polycystic ovary syndrome
- Endometriosis and Infertility
