Reproductive Immunology (Immune System)
Reproductive immunology is an emerging scientific field that looks to the immune system for explanations and treatment options for recurrent pregnancy loss and recurrent IVF implantation failures. It is a field of medicine that studies the interactions between the immune system and the reproductive system.
The immune system may react to an embryo as an "invader" and therefore try to stop the growth of these cells. The mother's body creates inflammation in the uterus, which we call regional inflammation, in order to prevent the development of the embryo. In the field of reproductive medicine, many treatments are used to suppress the immune system to reduce inflammation and support successful pregnancy outcomes.
Especially in IVF treatments or recurrent pregnancy loss, the biggest problem is genetic problems in the embryo or deformities in the mother's womb. Immunological (immune) problems are just one of a wide variety of problems that can cause infertility or pregnancy loss. Genetic problems are unlikely to be an important cause of recurrent pregnancy loss and recurrent IVF failure, especially in young patients.
In the following cases, it is useful to focus on reproductive immunology.
- Three early pregnancy losses or IVF failures before age 35
- Two early pregnancy losses or IVF failures after age 35
- Previously detected immunological problems (such as rheumatism, Systemic lupus erythematosus, etc.)
- Previous pregnancies with abnormal fetal growth
- Those with children and multiple miscarriages while trying to have a second time
In treatment, besides standard or advanced IVF treatment protocols, treatment plans such as intralipid, adalimumab, low-dose aspirin and heparin are applied, starting with corticosteroids that will regulate complementary immunity, that is, reproductive immunology.
Reproductive Immunology Tests
While there are many immunological tests, it is generally agreed that the tests available today are not fully sufficient to identify specific problems. However, blood and pathology samples are taken to look at blood and uterine (endometrium) tissue samples to determine if there is abundant inflammation.
Antinuclear antibodies (ANA)
An antinuclear antibody test detects antibodies that are reactive to components of a cell's nucleus. It has been found that the risk of recurrent pregnancy loss is higher in those with a positive result.
Antithyroid Antibodies (ATA)
ATAs are associated with an increase in proinflammatory cytokines secreted by T cells in the womb. Therefore, high ATAs may affect implantation.
Natural Killer Cell
Natural Killer Cells (NK) are a type of white blood cell that performs many essential functions, including infections and destruction of cancerous cells. High levels of circulating NK cells are associated with recurrent pregnancy loss.
Auxiliary T 1 and 2 Test (Th1, Th2)
Helper T cells are a type of lymphocyte that can divide into Helper 1 and 2 cells. Th1 and Thr2 immune cells secrete cytokines that direct them to attack and kill cells they think are infected or abnormal. There is a natural balance between this system, but those with higher rates generally experience higher levels of infertility and pregnancy loss.
Regulatory T Cells (T reg)
Regulatory T cells are thought to play an important role in controlling a woman's immune system's tendency to reject a semi-foreign embryo.
Immune cells subgroup phenotyping (CD56 test)
It looks at the percentage of lymphocyte types in the blood according to the antigens on the lymphocytes (CD-3, CD-4, CD-8, CD-19, CD-5, CD56, CD16 ). Among these, early pregnancy losses were observed to be higher in those with high CD56 lymphocyte levels.
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