The role of autoimmune disorders (like type 1 diabetes, celiac, rheumatoid arthritis or hyperthyroidism, for example) in fertility and pregnancy is extremely controversial in our field. Different clinics can have widely different beliefs and practices. The mainstream view is to only screen for autoimmune diseases if you’re exhibiting signs of having them. Some “alternative” fertility clinics may choose to offer a full panel of autoimmune screening tests, even if you don’t have symptoms.
One of the challenges with screening for autoimmune conditions is that there’s no standard, agreed-upon test for ruling them out.
Nearly all doctors will order a TSH (thyroid test), and suggest further tests if something comes back that seems abnormal.
Many doctors will rule out diabetes through serum glucose levels and/or serum hemoglobin A1C levels.
A few doctors will try to rule out lupus using antinuclear antibodies, but that test is known for causing “false positives” – suggesting you have a disease that you don’t. That’s the reason most doctors won’t order deeper autoimmune screening tests.
If screening for autoimmune disease is controversial, it’s because the treatments are even more controversial!
Some treatments are well-known and accepted – like thyroid replacement for patients with hypothyroidism. But many others are far more controversial.
In this sea of controversy, some doctors will suggest blood thinners (aspirin, low-molecular weight heparins like Fragmin and Lovenox, Humigon, IVIG, LIT therapy, intravenous lipids, HCG and other intrauterine infusions, and others.) But many of these therapies come with many serious side effects.
We strongly recommend a second (or third!) opinion before you do extensive autoimmune screening tests or undergo medical therapy for autoimmune diseases.