PMID- 25827646
OWN - NLM
STAT- MEDLINE
DCOM- 20160115
LR  - 20150429
IS  - 1473-656X (Electronic)
IS  - 1040-872X (Linking)
VI  - 27
IP  - 3
DP  - 2015 Jun
TI  - Immunology and human reproduction.
PG  - 231-4
LID - 10.1097/GCO.0000000000000174 [doi]
AB  - 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.
FAU - Alecsandru, Diana
AU  - Alecsandru D
AD  - aDepartment of Immunology bDepartment of Reproductive Endocrinology and 
      Infertility, Instituto Valenciano de Infertilidad-Madrid, Rey Juan Carlos 
      University (IVI), Madrid, Spain.
FAU - Garcia-Velasco, Juan Antonio
AU  - Garcia-Velasco JA
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Curr Opin Obstet Gynecol
JT  - Current opinion in obstetrics & gynecology
JID - 9007264
RN  - 0 (HLA-C Antigens)
RN  - 0 (Receptors, KIR)
SB  - IM
MH  - Abortion, Habitual/genetics/*immunology/therapy
MH  - Embryo Implantation/genetics/*physiology
MH  - Embryo Transfer/methods
MH  - Female
MH  - HLA-C Antigens/*immunology
MH  - Humans
MH  - Immune Tolerance
MH  - Killer Cells, Natural/physiology
MH  - Placentation/*physiology
MH  - Pregnancy
MH  - Receptors, KIR/*physiology
MH  - Uterus/*immunology/physiopathology
EDAT- 2015/04/02 06:00
MHDA- 2016/01/16 06:00
CRDT- 2015/04/02 06:00
PHST- 2015/04/02 06:00 [entrez]
PHST- 2015/04/02 06:00 [pubmed]
PHST- 2016/01/16 06:00 [medline]
AID - 10.1097/GCO.0000000000000174 [doi]
PST - ppublish
SO  - Curr Opin Obstet Gynecol. 2015 Jun;27(3):231-4. doi: 
      10.1097/GCO.0000000000000174.