Motherhood 101: My Immunological Issue

My consultation with my immunological doctor proved to be productive. Aside from informing me of the different roles our immunity plays when getting pregnant, my latest lab tests have been able to identify the main culprit. For that fact, all praises to God for He is always on - time. 

If you are someone having unexplained infertility, curious about immunity in relation to pregnancy or quite a bio geek like me, allow me to share what I learned. As my immunological doctor discussed, there are 5 possible reasons why someone may not be getting pregnant.

The first one is a problem with recognition. The normal course of things is that when there is a foreign invader in our body - bacteria, virus, foreign body part (e.g. transplant) - our body will attack them via our immune system. If you think about it, being pregnant is having a foreign invader inside you, as the baby is another human being. But, the special design is that when a woman gets pregnant, her immune system receives signals from the tiny fetus, most are hormonal but some are genetic in nature. With these signals, the woman's immune system creates protective blocking antibodies that will coat the baby's cells to protect the fetus from the mother's killer cells. That antibody is called the leukocyte antibody. More of that discussion can be found in http://www.sharedjourney.com/define/lad.html.

The second and third possible reason has something to do with support - you have gotten pregnant but the pregnancy doesn't continue. 

The second one is what is called the Antiphospholipid Antibody Syndrome (APAS), which I have already mentioned in my previous posts. The antiphospholipid antibody is a naturally occurring protein in our body but that mistake cells in our bodies as invaders. They attack by binding to a cell’s membrane making them sticky which causes improper blood flow and can contribute to the formation of blood clots. This can therefore compromise the connection of the mother and child, cutting off the fetus from oxygen and nutrients it needs to grow. APAS however is not only for women with fertility problems. As it is, it is an autoimmune disorder. 

The third one, which is also for support, is called the Antinuclear Antibody (ANA).  These antibodies exist to attack nuclei, the brain center, of invading cells keeping us healthy. But, sometimes, our bodies can mistake its own cells as invaders. ANA, therefore, attack the nuclei of normal cells. Read on http://www.sharedjourney.com/define/ana.html to know more.

The fourth one is the antisperm antibody. Having this antibody simply says that a woman is allergic to her partner’s sperm. How and why that happens is a different league altogether. When a woman is allergic, the sperm’s motility is affected and may also be unable to gain entrance to the egg cell.

The last one has something to do with the natural killer cells (NK cells) in our body.  NK cells are the body’s early response to usual infections. Every organ has NK cells to protect it with the womb having the most. If NK cells in a woman’s body are higher than usual or they are aggressive than usual, they may end up attacking the pregnancy rather than protecting it.

My case is mainly caused by my lack of leukocyte antibodies. Although, as I have also mentioned before, one of the parameters of my APAS test was borderline so my doctor is treating me as an APAS patient as well. As treatment for my APAS, I need to drink aspilet nightly even before I get pregnant.

On the other hand, the treatment for my lack of leukocyte antibodies is to undergo lymphocyte immunization therapy (LIT). LIT starts with blood extraction from a donor. The white blood cells from this blood will be separated which will then be injected under my skin – sort of how a vaccine works. I was prescribed 4 sessions of LIT to get the level of my leukocyte antibodies to the desired value.

We haven’t started on my LIT sessions yet but we plan to start this coming month. I thank God He has already provided us with blood donors among friends and we just need to have them screened off certain diseases before we bring them in the clinic. We're also just clearing ourselves of unnecessary stress before we do start. Work, particularly mine, hasn't been friendly this couple of weeks. But, thankfully, that's over. Now, we're really just depending on God for what we're going to go through. Our prayers are for the sessions to be effective and for provision.

Motherhood 101: The Saga Continues...

We’ve already crossed that 1 year and a half of waiting to be pregnant and we’re still not. I originally wanted to chronicle this journey of mine to educate and share my experiences to others but failed to do so as life happened. See, I’m not really a writer so in order to write I need to sit down, focus and be consumed by an urge to write something.

Before I continue, allow me to say that this journey is a battle and not an easy one. I’ve had my share of not-so-proud-of-myself self-pity moments as well as the crazy cry-one-day-laugh-the-next moments. This story has tested my limits physically, mentally and most especially, spiritually. And, as I write, I know I am still being tested each day but, in all this, God has showed me He is and forever will remain sovereign.

In my last entry about this I listed the possible causes of recurrent miscarriage. Ever since that time, I underwent a number of tests that thankfully, all turned out to be negative but one that gave borderline results. This test is my APAS lab test. 

In keeping with an informative format of sharing my story, allow me to define APAS. APAS or Antiphospholipid Antibody Syndrome is “a group of clinical manifestations associated with the presence of high levels of antiphospholipid antibodies in the blood … associated with recurrent thromboses (formation of blood clots) in the venous or arterial circulation” (www.myvmc.com/diseases/antiphospholipid-antibody-syndrome-apas). This means that it is possible (because of my borderline results) that when an embryo attaches itself to my uterine wall to get nutrients delivered by my blood, that connection could clot and thereby, cut off the oxygen and nutrients needed by the embryo to grow.

With my lab results, my doctor’s recommendation is to take aspirin, a blood thinner, once I get pregnant. However, after more than a year and a half wait, my REI doctor is recommending additional procedures and one of which is to check with an immunological doctor. The reason being is that one’s immunity can affect pregnancy before, during and after it happens, the details of which merits a totally different entry. However, if you want to be informed, I recommend visiting www.natural-fertility-info.com/immune-infertility.html.

We’ve already consulted with an immunological doctor and have begun the second phase of this journey. I’m not sure how long this will last but something inside me tells me we’re down to our last stretch. Ofcourse, the outcome of all this I am absolutely certain I want to go in one direction but, I know, whatever the outcome will be is all under God’s will. Still I pray, and invite you to pray with me, that I will be able to write about better days and answered prayers soon.     

Motherhood 101: My "Infertility" Story

Whenever friends and family hear what happened to me, they either end up doing 2 things: asking me why or offering possible scenarios why. I believe both spring from their concern for me but my story is not as simple as everyone would like to think just as getting pregnant is not as simple as having a sperm and an egg meeting each other.

Twice I got pregnant and twice I miscarried. In both cases, a heartbeat was seen during my first ultrasound. The first time I found out I was pregnant, I was already in my 6 weeks. At the 8^th week, I started bleeding and that’s when we found out that our baby grew up to only 6 weeks and 5 days. The second time I found out I was pregnant, I had an ultrasound at my 7^th week. Then, on a routine checkup at my baby’s would-be 13^th week, we found out our baby only reached 9 weeks.

My case is a case of recurrent miscarriage. But it is not something that can be prevented by extreme bed rest. You see, fetal death occurred first way before I miscarried. And, a case of recurrent miscarriage is better handled by an OB GYN  specializing in Reproductive Endocrinology and Infertility (REI).

My REI doctor is a good friend of my OB GYN. She practices at St. Luke’s but her consultation fee is relatively cheap compared to other REI doctors. ( If you want to know details about her, leave a message and I’ll give her details ;) ). Our first consultation with her was more about a discussion of the possible causes. She wanted to educate us about what’s happening. And right now, I just want to share what I learned from her.

A miscarriage or a recurrent miscarriage can be caused by any of the factors below.  These possible factors make the treatment of recurrent miscarriage quite hard, not to mention, expensive.

Anatomy – The walls of a uterus is supposed to be smooth. This is where a fertilized egg attaches itself and starts to draw blood from the mother so that it will be able to grow. However, sometimes a uterine wall may have polyps, adhesions and/or myoma. When a fertilized egg attaches itself to a polyp or adhesion, the supply of blood may become inadequate after a certain time specially because a growing baby will have growing needs. This inadequacy may result to fetal death.

Metabolic – Metabolic problems are problems such as diabetes or thyroid disorder. Now, I don’t know much about how this may cause fetal death but here’s what I know. About 15% of miscarriages can be accounted to this problem.

Genetic – An egg and a sperm both contain genetic codes that would direct how a fertilized egg will grow to be a human being. If there is a genetic abnormality in either egg or sperm, full development is not ensured.

Infection – There are some diseases that, when one is exposed to while pregnant, may cause miscarriage. This diseases are toxoplasmosis, rubella (measles), cmv and herpes.

Immunological – A pregnant woman’s immune system should be able to recognize the baby as part of her body. If a woman’s immune system is malfunctioning, her immune system will “attack” the baby in that the blood in the connection of the mother and the baby will clot. This will cut off the supply of blood the baby needs from the mother and may also cause fetal death.

Environmental – Certain stuff found in a mother’s environment (working environment, living environment, etc.) may be harmful to her and her baby. If exposed to certain chemicals or substances, this may also cause miscarriage.

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With these possible causes, don’t you just realize how complicated getting pregnant is? Kaya sinasabi talaga ng iba, pag sayo, sayo, pag hindi, hindi.  After our first consultation, our REI ordered as many tests as she can to rule out as many possible reasons as we can. But, more on the procedures and tests I had next time. This is way too much already.