Immunology, Autoimmune Conditions and IVF

If you are living with an autoimmune condition and trying to conceive, it is completely understandable to feel uncertain. Questions about safety, success rates and the impact of your  condition on fertility treatment are very common. 

The reality is that the relationship between the immune system and fertility is complex — but,  when approached correctly, it can be managed. The key lies in understanding when  

immunology is relevant and, most importantly, in applying a personalized, evidence-based  strategy. 

At Tambre, with almost 50 years of experience in reproductive medicine, complex cases like  these are approached through a dedicated multidisciplinary framework, where immunology  plays a targeted — not routine — role. 

How the immune system influences fertility and implantation 

The immune system is designed to protect the body. However, in autoimmune diseases, this  defense mechanism becomes dysregulated and may target healthy tissues. 

In reproductive terms, this imbalance can interfere with one of the most delicate processes in  human biology: embryo implantation. 

As Dr. Abraham Zavala explains: 

“Successful implantation is not just about tolerance. It requires an active and highly  

coordinated dialogue between the embryo and the maternal immune system.” 

This interaction involves immune cells, cytokines and signaling pathways working together.  When this balance is disrupted, several outcomes may occur: 

• Implantation failure  

• Recurrent miscarriage  

• Altered placental development  

• Pregnancy complications such as pre-eclampsia  

Some mechanisms are systemic — for example, antiphospholipid antibodies — while others  occur locally within the uterus, such as the interaction between uterine Natural Killer (uNK)  cells and the embryo. 

A key emerging factor is: 

“The interaction between maternal KIR receptors and embryonic HLA-C molecules, which is  increasingly recognised as relevant for implantation success.” 

However, an essential clinical message remains:

Not every laboratory finding translates into a real clinical problem. 

This is why interpretation — not just testing — is critical. 

When should immunological testing be considered? 

Immunological testing is not recommended for all IVF patients. 

A selective approach is essential to avoid overdiagnosis, unnecessary treatments and added  emotional burden. 

According to clinical practice, patients who may benefit include: 

• Recurrent miscarriage (two or more losses)  

• Recurrent implantation failure, especially with good-quality embryos  

• Diagnosed autoimmune diseases  

• Unexplained infertility with clinical suspicion of immune involvement  

As Dr. Zavala emphasises: 

“Indiscriminate screening can lead to anxiety and treatments that are not evidence-based.  Patient selection is key.” 

Autoimmune diseases and fertility: what is the real impact? 

Not all autoimmune conditions affect fertility in the same way. The impact depends on: 

• The type of disease  

• Its level of activity  

• The treatment required  

Among the most relevant conditions: 

Systemic lupus erythematosus (SLE) 

Can affect ovarian reserve and increase pregnancy complications. It is often associated with  antiphospholipid syndrome. 

Antiphospholipid syndrome (APS) 

A well-defined cause of recurrent miscarriage, linked to blood clot formation. Importantly, it is  treatable once diagnosed. 

Hashimoto’s thyroiditis 

Even when thyroid hormone levels appear normal, immune dysfunction may increase  

miscarriage risk, making proper monitoring essential.Multiple sclerosis (MS) 

Does not cause infertility but requires careful planning. Fertility treatment is possible when the  disease is stable. 

Rheumatoid arthritis 

Chronic inflammation and some treatments may influence reproductive health. 

Type 1 diabetes mellitus 

Poor control can affect both female and male fertility and increase pregnancy risks. 

What’s new in reproductive immunology in 2026? 

Recent advances are not about doing more tests — but about doing them better. 

Key developments include: 

1. More refined KIR/HLA-C analysis 

Understanding both maternal and embryonic genetic contribution provides a more complete  picture of immune compatibility. 

2. Clearer clinical guidelines 

Recent recommendations highlight the need for confirmed biomarkers before starting any  immunological treatment, avoiding empirical approaches. 

3. Endometrial immune profiling 

Research is focusing on analysing the uterine immune environment, although this is still under  investigation. 

4. Data-driven personalisation 

The integration of immunological, genetic, embryological and clinical data allows for truly  

individualised treatment strategies. 

A real clinical case: when immunology makes the difference 

A recent case treated at Tambre illustrates how a targeted immunological approach can change  outcomes: 

A 36-year-old patient had experienced three failed embryo transfers with good-quality  

embryos in another clinic. 

A focused immunological assessment revealed: 

• KIR AA genotype in the patient  

• HLA-C2/C2 profile in her partner  

This combination is associated with higher immunological risk.

Following optimisation of thyroid function and a personalised embryo transfer protocol with  immunomodulatory support: 

• Implantation was achieved in the next cycle  

• A single euploid embryo was transferred  

• The patient delivered a healthy baby at term  

This case highlights an important principle: 

Immunology is not always the answer — but in the right patient, it can be निर्णative. 

Strategies to optimise IVF outcomes in patients with autoimmune conditions 

Fertility treatment is safe in women with autoimmune diseases, but outcomes improve  

significantly when the condition is properly managed beforehand. 

Key strategies include: 

• Ensuring disease stability before treatment (often around six months, depending on  

the case)  

• Comprehensive evaluation of medical history  

• Personalised treatment planning  

• Healthy lifestyle: nutrition, exercise and stress management  

• Use of advanced embryo selection techniques, including Preimplantation Genetic  

Testing (PGT)  

• Close monitoring throughout the process  

At Tambre, these elements are integrated into a coordinated approach that adapts  

continuously to each patient’s evolution. 

Final message: precision, not over-treatment 

The role of immunology in IVF has evolved significantly. The focus is no longer on testing  

everything, but on understanding what truly matters for each individual patient. 

For those facing repeated IVF failures or complex diagnoses, immunology can open a new path  — but only when applied with precision, experience and scientific rigour. 

If you would like to understand whether immunology could play a role in your case, seeking a  specialized evaluation is the first step towards clarity — and, potentially, towards a different  outcome.

Tambre is an advanced reproductive medicine group with clinics in Madrid and Alicante, Spain.  Founded in 1978, Tambre has almost 50 years of experience supporting patients with  

personalized fertility care, with a special focus on complex cases, second opinions, and precise  diagnosis. 

About Dr Abraham Zavala 

Dr Abraham Zavala is a gynaecologist specializing in assisted reproduction and Medical  

Coordinator at Clinic Tambre Alicante. His clinical work focuses on patients with fertility  

challenges, particularly complex cases such as recurrent miscarriage and recurrent  

implantation failure.