Infertility, the AutoImmune Protocol, and the Double-Edged Sword of Prednisone

In addition to living with Crohn’s disease, I’ve also struggled with infertility.

In 2018, I went through almost a year of fertility treatments after a year of trying to get pregnant on my own before conceiving my daughter, and during my pregnancy, my IBD was the best it’s ever been. My gastroenterologist joked that I should try to just have a few back-to-back pregnancies to keep my IBD in remission.

If getting pregnant were easier for me, I would’ve done so in a heartbeat.

Struggling with infertility

A few months after having my daughter, my husband and I went back to trying to conceive naturally in order to have a second child. To make a long, long, story short, the journey to baby number 2 has been much harder and much longer than the first one. It’s been filled with failed fertility treatments, early miscarriages, surgery for endometritis, and a lot of questioning of my mind, my body, and my resolve.

This summer, my fertility doctor and I decided to take a different approach to treatment.

What is the autoimmune protocol?

There is something in the infertility space known as the “autoimmune protocol” – a medication protocol used during fertility treatments such as IUI and IVF which considers the body’s response to an embryo as hostile, and therefore protects the embryo at greater lengths.

As someone who lives with both Crohn’s disease and rheumatoid arthritis, this notion wasn’t one out of left field for me. My body attacks its own tissues and organs as foreign, so it wasn’t completely impossible for it to be treating a potential pregnancy the same way.

The autoimmune protocol involves taking a combination of a steroid (prednisone), an antihistamine (Claritin), and an antacid (Pepcid) to, in effect, quiet the immune response and allow an embryo to implant in the uterus and then begin to divide and grow into a healthy baby.

These medications are started anywhere from 1-3 weeks prior to treatment, and if a pregnancy is confirmed, they are continued through the end of the first trimester (or 12 weeks into pregnancy).

Steriods are part of autoimmune protocol

In addition to sharing more about infertility and the autoimmune protocol, what I want to share more about today is how taking prednisone, even "off label" comes with both pros and cons for managing my Crohn's disease.

Let's start with the benefits of prednisone... While on prednisone, even a "low" dose of 10mg/day, I find that my baseline frequency and urgency to use the restroom is a little bit reduced. Typically I have 2-4 bowel movements a day, every day, and they are soft or sometimes closer to liquid. Since starting prednisone again, I've noticed that most days I'm only pooping 1-2 times, and the consistency is sometimes even a little more firm.

I also have a little extra flexibility in what I eat and how much I eat, and I don't often struggle with abdominal pain. These are for sure advantages, and something I'll be sorry to say goodbye to once I taper off the steroids.

The negative effects of steroids

Now, for the downsides... As anyone familiar with prednisone knows, there is always a double-edged sword. While I've been physically feeling a bit better during this time, I've found myself constantly famished, struggling even more than usual to sleep through the night, and struggling with some misplaced anxiety and even outward anger at the smallest of things.

With my Crohn's disease, taking a steroid during a flare is usually a necessary choice, and balancing the pros and cons is something I think I've learned to do in stride. To be honest, I didn't expect to have to apply this lesson during my struggles with infertility, but I'm grateful I'd already learned them when I wasn't so hopped up on hormones and emotions.

If you've taken prednisone or steroids for other conditions, how have they impacted your IBD symptoms? Can you relate to my experiences?