When speaking of infertility, the first impression on most people is advanced maternal age but for the physicians, “Immunological Infertility” is sometimes more difficult than therapy for advanced aging infertility. The reason for immunological infertility is diverse with broad scope that requires the rich experience and diagnosis by professional physicians and even interdepartmental total therapy plan in order to help the patient get pregnant and have children. 

　　Mr. Lu and his wife are young couple who have undergone a tough road to having children, bearing heavy physical and psychological pressure. In 2015, the couple has been seeking for medical help and has received multiple sessions of therapies in other hospitals previously but none of the session has yielded good news. Plus the multiple immunological issues, the couple was advised by CMUH to take the customized conditioning plan and the test tube baby treatment. The couple was not prepared psychologically and decided to adopt artificial insemination at other hospital but the result was repeated disappointment. In June, 2016, the couple returned to CMUH for medical help but they have wasted more than one year of time. 

Interdepartmental therapy for acquisition of quality egg and intracytoplasmic injection resulted in successful fertility and birth 
　　After careful examination, the couple worked with the professional collaboration of Department of Rheumatology physician to enter the test tube baby therapy. Continuous immunological therapy is maintained during the period of ovulation stimulation to assure better quality of the egg in addition to adjusting the membrane of the ovary and hormones in order to provide the most suitable implantation environment for the embryo. At the end, 11 eggs were taken successfully and sperms with good activity, shape and standard were selected to inseminate through single intracytoplasmic injection. There were nine good embryos cultivated with success. The first three were implanted and in half month the wife was pregnant. This July, the wife successfully delivered a daughter and the couple was so thrilled. They still freeze the six embryos in preparation of future hope. 

Reasons for immunological infertility is diverse and broad, only precision medication and therapy can enhance pregnancy rate and reduces miscarriage rate 
　　CMUH Reproductive Medicine Center Physician Mei-Heng Wang stated the reasons of “Immunological Infertility” include: anti-phospholipid antibody, lupus erythematosus, anti-thyroglobulin antibodies, or it could be the wife’s antibody against the sperm of the husband that causes damage to the sperm activity. Research suggests that these antibodies will work on the membrane cells of blood vessel walls and inhibit the generation of prostaglandin so that prothrombin will increase, triggering vasoconstriction and platelet agglutination, forming thrombosis and affecting pregnancy. 

　　The antibody not only can be treated with traditional low-dosage aspirin or steroids, the use of thyroid hormones and heparin can also increase 10% to 20% pregnancy rate. Among the cases of autoimmune antibody and uneasy implantation or susceptible miscarriage, the cases with proactive treatment can also increase the success rate from 26% to 40% through test tube treatment while the miscarriage rate after pregnancy can also drop from 40% to 11%. The effect of proactive treatment helps 70% of patients complete the dream of carrying an adorable baby home. 

　　Physician Mei-Heng Wang stated that in the therapy of infertility, particularly the traditional unknown infertility, the problems with autoimmune antibody have already drew considerable attention. Even if the patients have other complications of infertility, early therapy can also significantly improve pregnancy rate and reduce miscarriage rate. 

　　“We would like to thank physician Wang for making our life complete.” The couple took the one-month-old baby for revisit and examination, who were filled with happiness and satisfaction. Looking back their difficult and perseverance in the course of infertility, their persistence has touched everyone. There are still couples who have similar conditions as Mr. Lu and his wife and they are still fighting along the way. Only incessant persistence without giving up can help those patients find the right path and get pregnant.

CMUH Reproductive Medicine Center Physician Mei-Heng Wang