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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Alecsandru, Diana García-Velasco, Juan Antonio |
| Description | Country affiliation: Spain Author Affiliation: Alecsandru D ( aDepartment of Immunology bDepartment of Reproductive Endocrinology and Infertility, Instituto Valenciano de Infertilidad-Madrid, Rey Juan Carlos University (IVI), Madrid, Spain.) |
| Abstract | PURPOSE OF REVIEW: The immune system's role in recurrent reproductive failure is a controversial issue in assisted reproduction. New insight about maternal tolerance in assisted reproduction has been reported and could explain some of the recurrent miscarriage and/or recurrent implantation failure related causes named until now as unknown. RECENT FINDINGS: Most of the previous studies about immune system implication in reproduction were focused on finding markers on peripheral blood. Maternal tolerance begins at the uterine level, so successful adaptation to the fetus happens after a complicated process. Insufficient invasion of the uterine lining by invading extravillous trophoblast is the primary defect in pregnancy disorders such as recurrent miscarriage, and this process is regulated by interaction between maternal killer immunoglobulin-like receptors (KIRs) expressed by the uterine natural killer cells and their ligand human leukocyte antigen (HLA)-C expressed by extravillous trophoblast. Pregnancies are an increased risk of disorders in mothers with KIR AA when the fetus has paternal HLA-C2. Recently, it has been reported that the expression of more than one paternal HLA-C by extravillous trophoblast in assisted reproduction may affect placentation in mothers with KIR AA. SUMMARY: The review provides insight about the immune tolerance process. These insights could have an impact on the selection of single embryo transfer and/or oocyte/sperm donor according to HLA-C in patients with recurrent miscarriage or recurrent implantation failure and a KIR AA haplotype. |
| File Format | HTM / HTML |
| ISSN | 1040872X |
| Issue Number | 3 |
| Volume Number | 27 |
| e-ISSN | 1473656X |
| Journal | Current Opinion in Obstetrics and Gynecology |
| Language | English |
| Publisher | Lippincott Williams & Wilkins |
| Publisher Date | 2015-06-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Obstetrics Discipline Gynecology Abortion, Habitual Immunology Embryo Implantation Physiology Hla-c Antigens Placentation Receptors, Kir Uterus Genetics Therapy Embryo Transfer Methods Female Humans Immune Tolerance Killer Cells, Natural Pregnancy Physiopathology Journal Article Review |
| Content Type | Text |
| Resource Type | Article |
| Subject | Obstetrics and Gynecology |
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