Abstract
When the impact of abnormal autoimmune function on female fertility is objectively examined, an unexpectedly large contribution is (auto)immune related. This may be surprising since many authorities have been dismissive of (auto)immune-associated infertility. In this article, we therefore summarize the link between abnormal autoimmune function and female infertility, based on literature searches. Abnormal autoimmune function affects female fertility at numerous levels of the reproductive process. As with autoimmune conditions in general, abnormal autoimmune function affecting fertility is often difficult to diagnose since it frequently presents subclinically, without overt clinical symptoms. It also demonstrates other characteristics of abnormal autoimmunity, such as familial occurrence and genetic predisposition, environmental cofactors contributing to phenotypic expression of genetic risk and cyclicity of occurrence, often characterized by gestational exacerbation patterns. Proven treatments for autoimmune-associated infertility have not been established to date. This fact should, however, not preclude efforts to reach correct diagnoses, since only accurate diagnoses can lead to appropriately conducted clinical trials.