Immunology of Recurrent Pregnancy Loss and Implantation Failure

Immunology of Recurrent Pregnancy Loss provides doctors and immunologists with the information they need to help couples who experience recurrent pregnancy losses. Sections cover unexplained infertility, repeated in vitro fertilization, embryo transfer failures, history of second or third trimester pregnancy losses of unknown cause, or pregnancy with a history of or active autoimmune and/or alloimmune disease. Reproductive failure (RF), including recurrent pregnancy losses (RPL) and repeated implantation failures (RIF) is rather a syndrome than a disease caused by multiple etiologies, such as anatomical, endocrine, genetic, infectious, immunological, thrombotic and unexplained etiologies, hence this book strives to present the latest information.

In 27 chapters, divided in 5 sections, the book introduces the current update of reproductive immunology topics in RF and provides systematic diagnostic guidelines, systemic and immune etiologies and therapeutic approaches.

Cover image
Title page
Table of Contents
Copyright
List of contributors
About the editor
Section I: Introduction
Chapter 1. Clinical reproductive immunology: a window to understanding reproduction and immunology
Abstract
References
Section II: Recurrent pregnancy losses
Chapter 2. Natural killer (NK) cell pathology and reproductive failure: NK cell level, NK cell cytotoxicity, and KIR/HLA-C
Abstract
1 Introduction
2 Natural killer cells—definition
3 Natural killer cell-related pathologies
4 Natural killer cells in reproduction
5 Evaluation
6 Reproductive outcome
7 Treatment
8 Summary and recommendations
References
Chapter 3. T helper cell pathology and recurrent pregnancy losses; Th1/Th2, Treg/Th17, and other T cell responses
Abstract
1 The immunologic perspective of recurrent pregnancy loss
2 Definition and prevalence of recurrent pregnancy loss
3 Prevalence
4 Immune regulations in normal pregnancy and recurrent pregnancy loss
5 Diagnostic approaches
6 Treatment and reproductive outcome
7 Summary and recommendations
References
Chapter 4. B cell pathology and recurrent pregnancy loss
Abstract
1 Introduction
2 B cell function during pregnancy
3 Immunopathologies related to reproduction
4 Recurrent pregnancy loss
5 Diagnosis
6 Treatments
7 Summary and recommendations
References
Chapter 5. Mast cell pathology and reproductive failures
Abstract
1 Introduction
2 Mast cells biology
3 Role of mast cells in reproductive system
4 Mast cell-related immunopathology in reproduction
5 Summary and Recommendation
References
Chapter 6. Role of human leukocyte antigen in the pathogenesis of recurrent pregnancy loss
Abstract
1 Introduction
2 Recurrent pregnancy loss and human leukocyte antigen studies
3 Human leukocyte antigen class I and II molecules
4 Evaluation of human leukocyte antigen antigens in assisted reproduction
5 Treatment
6 Conclusions
7 Summary and recommendations
References
Chapter 7. Stress-induced immune deviations and reproductive failure
Abstract
1 Immune-endocrine adaptations during normally progressing pregnancies
2 Maternal stress perception
3 The prevalence of stress
4 Neuro-endocrine-immune imbalances and pregnancy
5 How to assess stress perception?
6 How to treat high-stress perception?
7 Consequences of maternal stress on reproductive outcome
8 Summary and recommendations
References
Chapter 8. Antiphospholipid syndrome and recurrent pregnancy losses
Abstract
1 Introduction
2 Evaluations
3 Clinical practice management
4 Monitoring
5 Delivery and puerperium
6 Fetal and neonatal outcome
7 aPL and infertility
8 Summary and recommendations
References
Chapter 9. Antisperm antibodies and reproductive failure
Abstract
1 Introduction
2 Definition
3 Prevalence
4 Underlying immunopathologies related to reproduction
5 Evaluation
6 Treatment
7 Reproductive outcomes
8 Summary and recommendations
References
Chapter 10. Antithyroid antibodies and reproductive function
Abstract
1 Introduction
2 Definition of autoimmune thyroiditis
3 Prevalence
4 Underlying immunopathology
5 Evaluation
6 Treatment
7 Reproductive outcomes
8 Summary and recommendation
References
Chapter 11. Fetal/neonatal alloimmune-mediated thrombocytopenia and recurrent pregnancy loss
Abstract
1 Introduction
2 Definition
3 Prevalence
4 Underlying immunopathology related to reproduction
5 Evaluation
6 Treatment
7 Reproductive outcomes
8 Summary and recommendations
References
Chapter 12. Infectious and noninfectious endometritis and recurrent pregnancy loss
Abstract
1 Introduction
2 Definition
3 Summary and recommendations
References
Chapter 13. Thrombophilic pathologies in recurrent pregnancy losses
Abstract
1 Introduction
2 Thrombophilia
3 Physiologic hypercoagulability in pregnancy
4 Inherited thrombophilia and recurrent pregnancy loss
5 Evaluation
6 Treatment of inherited thrombophilia
7 Reproductive outcomes
8 Summary and recommendations
References
Chapter 14. Rheumatic diseases and reproductive outcomes
Abstract
1 Rheumatic conditions and pregnancy outcome
2 Rheumatoid arthritis
3 Systemic lupus erythematosus
4 Systemic sclerosis
5 Antiphospholipid antibody syndrome
6 Neonatal lupus
7 Conclusion
8 Summary and recommendations
References
Section III: Repeated implantation failures
Chapter 15. The role of reproductive immunology in recurrent pregnancy loss and repeated implantation failure
Abstract
1 Introduction
2 Definitions and terminology
3 Prevalence
4 Underlying immunopathology related to reproduction
5 Evaluation
6 Treatment
7 Reproductive outcomes
8 Summary and recommendations
References
Chapter 16. The embryo in reproductive failure: immunological view
Abstract
1 Introduction
2 Embryo-derived signals influencing the local immune environment
3 Embryo-endometrial dialogue
4 Recurrent implantation failure
5 Improving implantation rate
6 Immunomodulation
7 Summary and recommendations
References
Chapter 17. Natural killer cell pathology and repeated implantation failures
Abstract
1 Introduction
2 Natural killer cell and pregnancy
3 Underlying immunopathologies related to reproduction
4 Candidates for evaluation
5 Treatment
6 Summary and recommendations
References
Chapter 18. Helper T cell pathology and repeated implantation failures
Abstract
1 The role of helper T cells in reproductive medicine
2 Th cell immunopathology and repeated implantation failure
3 Prevalence
4 The theoretical understanding for the application of immunomodulation therapy in recurrent implantation failure
5 Evaluation
6 Immunomodulation treatments targeting T helper cell pathology
7 Reproductive outcome
8 Summary and recommendations
References
Chapter 19. B-cell pathology and repeated implantation failures
Abstract
1 Introduction
2 B-cell immunopathology and reproduction
3 Dysregulation of B cells in women with repeated implantation failure
4 Clinical translational perspectives of B-cell immunopathology
5 Summary and recommendations
References
Chapter 20. Endometrial pathology and repeated implantation failures
Abstract
1 Introduction
2 Endometrial pathologies
3 Endometrial immunopathology
4 Immune treatments for women with abnormal immune profile
5 Key points
References
Chapter 21. Thrombophilia, antiphospholipid antibodies, and anticoagulation in recurrent implantation failure
Abstract
1 Introduction
2 Definition of thrombophilia
3 Prevalence
4 Underlying immunopathologies related to reproduction
5 Diagnosis
6 Treatment
7 Summary and recommendations
References
Section IV: Dysregulated neuroimmuneendocrine network in reproductive failures
Chapter 22. The ovarian immune pathology and reproductive failures
Abstract
1 Introduction
2 Ovarian immunology
3 Ovarian autoimmunity
4 Primary ovarian insufficiency
5 Diseases associated with ovarian autoimmunity
6 Diagnosis of primary ovarian insufficiency
7 Treatment for autoimmune primary ovarian insufficiency
8 Reproductive outcomes
9 Summary and recommendations
References
Chapter 23. Polycystic ovarian syndrome and reproductive failure
Abstract
1 Introduction
2 Hyperandrogenism and reproductive failure in polycystic ovarian syndrome
3 Insulin resistance and reproductive failure in polycystic ovarian syndrome
4 Chronic inflammation and reproductive failures in polycystic ovarian syndrome
5 Conclusion
6 Summary and Recommendations
References
Chapter 24. Metabolic control of immune responses in women with recurrent pregnancy loss and recurrent implantation failure
Abstract
1 Introduction
2 Definition and prevalence
3 Underlying immunometabolic pathologies related to recurrent pregnancy loss and recurrent implantation failure
4 Evaluation
5 Treatment and reproductive outcomes
6 Summary and recommendations
Fundings
References
Chapter 25. Endometriosis and reproductive failures
Abstract
1 Introduction
2 Mechanism of endometriosis-related reproductive failure
3 Immune aspect of endometriosis-related pregnancy failure
4 Treatment options
5 Summary and recommendations
References
Chapter 26. Laboratory approaches for reproductive failure: immunological biomarkers for reproductive failures
Abstract
1 Genomic evaluation
2 Local decidual measurements
3 Peripheral blood cell analysis
4 Autoantibodies in recurrent pregnancy loss
5 Endocrine workup
6 Other assays
7 Summary and recommendations
References
Further reading
Index

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Immunology of Recurrent Pregnancy Loss and Implantation Failure

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Joanna Kwak-Kim