Infertility due to incompatibility. Incompatibility of partners during conception, its types and treatment. Immunological incompatibility of spouses

Very often we hear such stories when a seemingly absolutely healthy man and woman cannot have a child for a long time. And in some cases, when a couple breaks up, with other partners they can have a baby quite quickly. In such situations, it is customary to talk about the incompatibility of spouses for conception. I explore the reasons for what is happening, science finds more and more subtle reasons and selects treatments to overcome them.

There are several types of incompatibility: incompatibility by and, genetic, immunological incompatibility. This may manifest itself:

• Inability to conceive a child at all;
• Conception occurs, but a miscarriage occurs (sometimes the woman does not even suspect that she was pregnant);
• Intrauterine death or the birth of a non-viable baby occurs.

remember However, such a diagnosis is not a death sentence. Science does not stand still and finds new treatment methods so that a couple can have a healthy baby.

Incompatibility by Rh factor and blood group

A system of antigens (special proteins) on human red blood cells, which begin to be synthesized from 6-8 weeks of intrauterine development and remain unchanged throughout life. About 85% of the population have these proteins (are Rh positive), the rest do not have them (Rh negative). The Rh factor is inherited from the parents. If both parents have a negative Rh factor, then the child can only be negative. In other cases there may be options.

important If a woman is Rh-negative and a man is Rh-positive, then there is a chance that the fetus will also develop (if the baby inherits the father’s blood).

The conflict occurs because the baby’s red blood cells, once in the mother’s bloodstream, stimulate the formation of Rh antibodies (special proteins) in the woman. They settle on the baby’s red blood cells and damage them, which leads to the development of hemolytic disease of the fetus.

The mechanism for the development of blood group conflict is similar to the previous one, but it proceeds more easily. This happens if the mother has the first blood group, and the baby has any other blood type other than female.

Genetic incompatibility

Indications for genetic compatibility testing:

• A man and/or woman who has a severe genetic disease (hemophilia, cystic fibrosis) or there have been cases of the birth of children with hereditary diseases in their families;
• Age of spouses;
• There were numerous;
• Spouses are relatives;
• The couple lives in an environmentally unfavorable area;
• of unknown origin.

Research is conducted to determine the risk of having a child with genetic disorders and to identify interventions that can improve the likelihood of having a healthy baby.

Immunological incompatibility

Immunological incompatibility is said to occur when the body's defense system prevents the child from being born. This can happen for many reasons, but the most common and studied are the presence of similar genes in the human HLA system and the presence of antisperm antibodies in the body of a man or woman.

HLA incompatibility

HLA (histocompatibility antigens) are special proteins located on human cells that help recognize self and foreign (bacteria, viruses) cells. With the help of these antigens, one’s own altered cells are also detected, and then a signal is transmitted to the immune system, which destroys them.

Histocompatibility antigens are inherited from mother and father. If the HLA system genes of the parents are similar, then the mother’s immune system may mistake the fetus for its own altered cells and try to remove them, which leads to an early spontaneous miscarriage.

information Therefore, the more different the genes of mom and dad are, the greater the likelihood of bearing a child.

Antisperm antibodies

Antisperm antibodies (ASAT) are proteins against male germ cells (sperm).

These antibodies damage sperm, preventing them from moving through the woman’s reproductive tract, which prevents the fertilization of the egg and can lead to infertility.

Normally, they can be found in a man, but on no more than 10% of the sperm in the ejaculate (sperm).

Trauma to the scrotum, infectious diseases of the reproductive system, varicocele (varicose veins of the spermatic cord), surgical interventions on the male genital organs contribute to the appearance of antibodies.

In women, ASAT appears after inflammatory processes, hormonal disorders, and the use of spermicides. There is especially a lot of ASAT in the cervical mucus. Meeting them on their way, sperm cannot pass through the cervix and reach the egg.

Identifying any incompatibility for conception in a married couple is an important step for prescribing treatment and further conceiving and bearing a long-awaited child.

It often happens that spouses are completely healthy, but they fail to conceive the long-awaited baby. The reason may be incompatibility of partners during conception, which is observed in 30% of cases of infertility.

We can talk about incompatibility only after a complete examination of both spouses in order to exclude other possible causes of infertility. If the couple is healthy, then the doctor may diagnose “incompatibility of partners at conception.” Spouses can note signs indicating pathology before visiting the doctor.

• Pregnancy does not occur within a year. If partners are sexually active and do not use contraception, but conception does not occur, incompatibility is obvious. In this case, it is recommended to undergo an examination to identify the cause.
• Regular miscarriages. They occur mainly in the first weeks of pregnancy. Even if pregnancy occurs, the mother’s body rejects the fetus.
• Itching and burning of the genitals after sexual intercourse. This factor indicates the incompatibility of the microflora of the partners.

Treatment of incompatibility will directly depend on its type and causes of occurrence.

Immunological

The common name for this species is biological incompatibility. It is the cause of infertility in 10% of cases. The essence of the pathology is that the female body perceives male sperm as foreign, dangerous and begins to produce antibodies to them. As a result, sperm die.

The mechanism of immunological incompatibility of partners for conception is very similar to an allergic reaction and can have several causes:

• weakened immunity of a woman or man (may be accompanied by an unhealthy lifestyle, chronic diseases in a sluggish form, previously undergone gynecological operations);
• an allergic reaction in a man to his own sperm, as a result of which the sperm die;
• frequent change of partners in the recent past;
• long-term use of condoms prior to conception.

Today, doctors cannot name all the reasons that determine the immunological incompatibility of partners for conception. Sometimes a woman is allergic to the sperm of a specific man, and sometimes to several partners.

There are many tests to determine immunological incompatibility. Both men and women need to go through them. As a result, the number of antibodies in the partner’s body, dead and living sperm, etc. is determined. For example, your doctor may suggest taking mucus from the cervix. The test is carried out 6 hours after the last sexual intercourse, but no later than 12 hours later. The consistency of mucus is studied using a microscope, sperm motility is assessed, etc.

Treatment can take place in several ways:

• the use of condoms to reduce the sensitivity of the female body to sperm;
• antihistamines and immunosuppressive drugs;
• immunostimulants;
• IVF (in vitro fertilization) if it is impossible to get pregnant naturally.

By Rh factor

Sometimes partners may experience blood type incompatibility. What matters is not so much the group itself as the Rh factor - positive or negative. The Rh factor is a protein compound found on the outer part of the red blood cell membrane. If the antigen is present, it is said to be rhesus positive; if it is absent, it is said to be negative.

Couples who have:

• positive Rh factor in a woman;
• Both partners have the same Rh factor.

If a woman is Rh negative and her husband is Rh positive, the first pregnancy can proceed normally. If they want to have a second child, such partners may have problems. The female body will reject the fetus as a foreign body, producing antibodies to the paternal Rh factor. The result is a miscarriage.

There is also a danger in the entry of blood with the opposite Rh into the mother’s body during childbirth. The immune system begins to actively produce antibodies, which invariably leads to complications.

It is easy to identify a Rh conflict in advance: partners just need to donate blood for a test. If the doctor is aware of the Rh conflict, he will take appropriate measures:

• three days before giving birth and several days after the woman is given immunoglobulin to suppress the activity of the immune system;
• In the absence of other treatment options, a blood transfusion is performed.

Blood type incompatibility is not a death sentence. Medicine has learned to cope with such problems. You just need to inform your doctor about them in time.

By microflora

It is stated only in 2-3% of cases of infertility. The reason is the perception of microorganisms in the partner’s microflora as pathogenic and posing a threat. In this case, sperm die in the woman’s microflora.

To determine this type of incompatibility, a smear of the microflora of the vagina or urethra and bacteriological culture are taken. With its help, the pathogen is determined and the incompatibility of the microflora of the partners is finally diagnosed. Treatment consists of taking antibiotics to which the pathogen is sensitive. After completing the course, a smear is taken again for analysis.

Genetic

Every human cell contains a leukocyte antigen, which protects against dangerous objects. If the set of chromosomes between partners is similar, pregnancy is perceived by the antigen as the introduction of a foreign body. An impulse is sent to the immune system, and the production of antibodies begins. The chance of bearing a child arises only with a different set of chromosomes.

To identify genetic incompatibility, you need to donate blood for analysis. The answer is given in 2 weeks. You can take this test at any genetic center.

The problem can only be solved using IVF (in vitro fertilization) or ICSI (artificial insemination) methods with the help of geneticists who will select an individual program for the couple.

If a married couple cannot conceive a child for a long time, the reason for this may not only be health problems. According to medical statistics, in 1 case out of 10 the cause of infertility is incompatibility of partners. In most situations this problem can be resolved. What types of partner incompatibility are there? By what signs in the process of planning conception can one understand that a man and a woman are incompatible? Is it possible to overcome the incompatibility of partners during conception?

What is needed for successful conception?

When spouses think about offspring, many of them mistakenly believe that for successful conception it is only necessary to have sex. Meanwhile, for pregnancy to occur, many factors must coincide:

• plan sexual intercourse in the middle of the menstrual cycle;
• choose positions in which sperm leakage from the vagina is less likely;
• by the time of trying to conceive, a woman and a man should take 2-3 courses of folic acid;
• it is desirable to get rid of addictions;
• It is advisable for future parents to be healthy.

In addition to these conditions for successful conception, the couple must have 100 percent compatibility. We are talking not only about the physiological compatibility of partners, but also genetic and immunological.

Why might partners be incompatible with each other?

Dear reader!

This article talks about typical ways to solve your issues, but each case is unique! If you want to know how to solve your particular problem, ask your question. It's fast and free!

There are several types of incompatibility during conception: physiological, biological (also called immunological), and Rh factor. What does each of these types of incompatibility of potential parents mean? Why do they occur and how common are they among married couples who want to have a child?

Physiological incompatibility

What does this type of incompatibility mean? In this case, we are talking about the discrepancy between the genital organs of a man and a woman: a too large penis and a narrow vagina, or, conversely, a small penis and a wide vagina. This type of incompatibility is the most easily overcome.

If desired, with such imbalances, spouses can become parents. Today, there are many ways to level out the difference between the sizes of the genital organs of sexual partners.

Incompatibility by blood group and Rh factor

There is an opinion that sometimes a woman cannot carry a baby if her and her husband’s blood types are incompatible. This is a myth, not scientifically confirmed. Among relatives and friends there will be people with supposedly incompatible blood groups who become parents. Another thing is the Rh factor. If there is an antigen in the human body, this indicator is positive; if absent, it is negative (denoted as Rh+ and Rh-).

Ideally, spouses should have identical Rh factors. However, this does not happen to all couples. A conflict between these indicators between the expectant mother and the fetus occurs in cases where her Rh factor is negative, and the baby’s is positive. This option is possible if the father’s blood contains the specified antigen. In this way, the woman’s immune system produces antibodies to the foreign protein.

This type of incompatibility does not mean that they will not be able to conceive a child. Pregnancy is possible, but there is a high risk of spontaneous abortion. Unlike the first pregnancy, which is considered relatively safe, the second can lead to serious consequences for the woman and baby. That is why abortions are contraindicated for women with a negative Rh factor of any blood type.

Incompatibility of genetic etiology

Genetic incompatibility of spouses is a fairly common occurrence. Experts note that recently, among couples planning to have a child, cases of conflict detection at the chromosomal level have become more frequent. Genetic compatibility is the absence of karyotype abnormalities in both spouses. To understand what genetic incompatibility is, you need to understand the mechanism of its occurrence.

The human body contains HLA genes. They are also called “histocompatibility antigens”. They are protein molecules and are located on the surface of almost all cells. They are more fully represented on the surface of leukocytes. HLA genes are divided into 2 types. HLA class II (leukocyte antigen) performs the following functions:

• identifies a pathogenic agent that promotes cell mutation;
• recognizes pathogens with its own genotype;
• determines changes in the structure of its own cell.

Every day certain cells undergo mutation processes. If they are destroyed in a timely manner, there is no danger. Their preservation threatens the development of malignant neoplasms.

The child’s HLA genes are a set of histocompatibility antigens of the father and mother. In most cases, these genes do not match, which means the spouses are genetically compatible. In this situation, when the fertilized egg is implanted, the female body perceives the fetus as a half “foreign” substance and begins to produce antibodies to the male’s HLA class II.

This measure is aimed at protecting and preserving the life of the child. With genetic compatibility, the expectant mother’s immunity ceases to perceive the embryo as a change in her own cells. As a result, the pregnancy develops safely.

If a husband and wife are genetically incompatible, their HLA is the same. The female body does not perceive the male component in small quantities. The immune system sees mutated maternal cells in the embryo and begins to fight them. This ends in fetal death or spontaneous abortion.

Incompatibility due to immunological factor

Biological incompatibility also has a negative impact on conception. This type occurs in 10% of infertile families. With immunological incompatibility, the female body perceives sperm as foreign elements. As a result of the formation of antibodies to the partner's seminal fluid, male germ cells die as soon as they enter the female reproductive tract. The mechanism of occurrence of this phenomenon is similar to how an allergic reaction to any foreign element occurs in the body.

How to check if a man and a woman are compatible when planning a pregnancy?

What to do if repeated attempts to get pregnant are unsuccessful? In this situation, you need to consult a doctor who will prescribe a compatibility test. There are a large number of analyzes (information about them is provided in the table below) that allow you to check how compatible partners are.

To determine the genetic compatibility of spouses, a venous blood test is done (more details in the article:). Initially, their DNA is analyzed and then compared. This procedure is called HLA typing. A postcoital test is also performed to identify active sperm.

Is it possible to overcome incompatibility and is it worth doing?

If incompatible spouses want to have a child, there is a way out of almost any situation. The solution to the problem depends on its type:

• Disproportion of the genital organs. If the penis is too large, you can put a special restrictive ring on it before having sex. If the vagina is wide, it is recommended to choose positions in which penetration will be deeper. As a last resort, they resort to surgical suturing of the vagina.
• Conflict of Rh factors. During the process of bearing a child, you need to use monthly tests to check for the presence of antibodies contained in the blood of the expectant mother. Shortly before delivery (3 days), the patient is given anti-Rhesus immunoglobulin, which is designed to prevent the formation of antibodies.
• Conflict at the chromosomal level. The method of therapy depends on the degree of similarity of the parents' genes. Medicines administered intravenously to the patient help the immune system recognize foreign chromosomes and not destroy them. As an alternative, in this case they resort to in vitro fertilization or intracytoplasmic sperm injection.
• Rejection of male genetic material by the female body. Antiallergic and immunostimulating medications and corticosteroids are used. It is recommended to use condoms before trying to conceive. Methods such as IUI, IVF, ICSI are also used.

When people meet, they fall in love with each other, get married, create their own social unit, and dream of soon becoming loving parents. But in reality, everything is not so fabulous and sometimes it is not possible to conceive a child the first time, and sometimes it is not possible to do this at all, despite the fact that everything is in order with the reproductive system of the spouses. Doctors call this phenomenon incompatibility of partners during conception.

An obvious sign of sexual disagreement between a man and a woman is the inability to conceive a child. Such incompatibility should be discussed in the case when it is not possible to get pregnant within a year with regular sexual activity. Sometimes it happens that partners are healthy, but all attempts remain in vain and people are forced to resort to the help of specialists.

Past diseases of the internal genital organs, hormonal and mental problems - all of these can be the reasons for a couple’s inability to fertilize.

In gynecological practice, there are several signs of incompatibility during conception:

• lack of conception for a long time;
• even if fertilization has occurred, the woman has a miscarriage in the first months of pregnancy;
• freezing of the fetus in the mother's womb or stillbirth.

The main cause of this pathology in a given case can be determined using special samples and tests (postcoital test, Shuvarsky and Kurzprock-Miller tests). Many pharmacological agents can distort research data, so at the time of testing it is advisable to avoid taking any potent and hormonal drugs.

Sexual incompatibility may be directly related to infertility, and in this case, fertilization can be carried out artificially in the laboratory. A compatibility test should be done when there is still a chance of achieving natural conception and fertilization.

An unambiguous decision on how to get pregnant if the spouses are sexually discrepant should be made by the attending physician. He will competently examine and select a set of necessary measures that are needed to eliminate the problem.

Types of incompatibility for conception

In turn, there are several types of such mismatch between partners during conception:

1. Immunological infertility. In simple words, such incompatibility of partners for conceiving a child is due to the fact that the woman’s immune system produces antibodies that do not allow male reproductive cells to penetrate the uterus, they damage and destroy them. The predominant amount of antibodies is found in the secretion of the cervix and they appear in a woman mainly after undergoing inflammatory diseases of the genital organs, hormonal imbalance, use of spermicides. Moreover, an excess amount of antibodies sometimes leads to toxicosis, miscarriages and problems in fetal development.

Sometimes this manifestation is also called an allergic reaction of the female body to male reproductive cells. Male ejaculate also contains such antisperm antibodies, but in much smaller quantities. According to recent studies, in 30% of cases this incompatibility factor is one of the causes of infertility. Spouses must undergo a test to determine immunological compatibility. In a special family planning clinic, a man must undergo a spermogram, the results of which will determine the condition of sperm and their motility.

Treatment of immunological incompatibility consists of partners fulfilling certain conditions:

• use barrier contraception for several months in order to reduce the sensitivity of the female body to sperm;
• take medications that suppress the action of free histamine;
• undergo a course of therapy to suppress such immune reactions of the body;
• be treated with immunostimulants;
• Sometimes the problem can be solved by injecting the partner's sperm into the uterus.

1. Genetic resonance is distinguished by one single symptom - fetal rejection, and this occurs due to different Rh factors in men and women. Incompatibility of blood groups during conception is a fairly common problem, and in order to conceive a child, both spouses must have the same Rh blood factor. Even if conception occurs and the woman manages to carry the child to term, health problems are possible after birth.

The Rh factor consists of special proteins (antigens) on human red blood cells, which, after their synthesis in the 7th week of intrauterine development, remain either positive or negative. This indicator, in turn, is inherited from the parents. If both parents have the same Rh factor, then the child will have the same. A conflict between the blood of the mother and the fetus can arise when the child inherits the positive Rh factor of the father, and the woman has a negative value.

To treat blood incompatibility and ensure the conditions necessary for conception, partners must undergo a mandatory medical examination. If an Rh conflict is detected, the doctor will most likely prescribe a certain dose of immunoglobulin. Then, in order to prevent possible negative consequences, the procedure is carried out at 28 weeks of pregnancy and a few days after delivery. If the incompatibility is severe, then, as a last resort, the woman is given a blood transfusion.

What should partners do if they are incompatible to conceive?

In order to find out whether the problem of lack of conception is really incompatibility, a woman should undergo a full gynecological examination, and a man should undergo an examination by a urologist. If there are no inflammatory processes and there are no other mechanical obstacles to conception, then other studies are carried out to identify immunological problems. In this case, it is necessary to determine the number of antisperm bodies in the body of a woman and a man, as well as the factors that provoke their formation.

Having established that the couple actually has an immunological incompatibility at conception, the doctor prescribes the woman special treatment with a mandatory post-coital test. On the eve of this study, the woman must meet the following conditions:

• three days before the test you need to abstain from sexual intercourse;
• Immediately 12 hours before the visit to the gynecologist, sexual intercourse with maximum loss of seminal fluid should occur. That is, after sexual intercourse it is undesirable to get up and move;
• Before the procedure itself, it is not recommended to wash your face or douche.

At the appointment, the doctor will take a small amount of mucus from the cervix, determine its consistency, stretchability and pH environment. At the same time, spermatozoa will be examined for viability. This test is to show what a woman’s reaction is to the sperm of her sexual partner.

Possible test results:

1. Positively. When it is established that when interacting with the secretion of the cervix, sperm motility is preserved. In this case, we can talk about the possibility of conception naturally.
2. Weakly positive. This result indicates reduced activity of male germ cells, which means that additional treatment is necessary for fertilization.
3. Negative. With such indicators, sperm were not able to penetrate the secretion at all. This can be facilitated by both mucus immunity and low semen quality.

If weakly positive or negative results are obtained, the woman is referred for further examination, since in addition to possible immunological reasons, the result indicators could be affected by an undetected inflammatory process of the internal genital organs.

IVF versus incompatibility

If partners cannot get pregnant for a long time, then both should undergo a compatibility test, during which blood will be taken for analysis, and a course of other tests will be prescribed.

There is no need to despair under any circumstances. Modern medicine does not stand still and various methods of treating and preventing the possible consequences of this pathology have long been developed. Incompatibility during conception can be treated and only a professional doctor can tell you what to do and guide you on the path to overcoming the problem.

Incompatibility during conception can be caused by infertility of one of the partners. The solution to this problem is artificial insemination.

Assisted reproductive technology IVF is salvation and a chance for successful motherhood and fatherhood. The essence of the method is to help families conceive and give birth to a healthy child.

The in vitro fertilization procedure consists of the following steps:

• collection of a mature egg from a woman;
• taking a certain amount of a man’s seminal fluid;
• introduction of sperm into a female egg in the laboratory;
• embryo cultivation;
• its introduction into the uterine cavity, where it should securely attach to its walls.

Further, the process of bearing and giving birth to a child will not differ from if the baby was conceived naturally. Contrary to all misconceptions, the IVF procedure is considered life-saving and gives future parents a long-awaited miracle.

Incompatibility at conception. Video

Is incompatibility of sexual partners a risk for a woman who may lose her baby or be unable to conceive? A detailed description of the problem of incompatibility, manifestations, symptoms and types of pathology below.

Test results: table

Rejection of the fetus by a woman’s body against the background of Rh conflict is the most common cause of infertility due to incompatibility. The basis of this process is the production of antibodies by the woman’s body that attack the baby’s body with a different Rh blood type. The most dangerous option is the first negative blood group in the mother.

Thanks to a special table, you can find out the incompatibility of sexual partners, reducing the results to one point. It is also important to consider the number of pregnancies. During the first conception, antibodies do not have time to accumulate in the required quantity, pregnancy occurs normally. While by the second pregnancy, the mother’s antibodies are already ready to recognize and eliminate the foreign body.

Lack of pregnancies or constant miscarriages for no apparent reason is not a reason to panic and divorce your loved one. This is just another reason