Natural killer cells in female infertility and recurrent miscarriage: a systematic review and meta-analysis

Seshadri, Srividya; Sunkara, Sesh Kamal

doi:10.1093/humupd/dmt056

Cited by 249 publications

(203 citation statements)

References 64 publications

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“…Chlamydia and gonorrhea are most common STI which lead to infertility in men and women. Chlamydia is among the most common STI in England and 196 new cases affected with this infection were identified in 2011; youth (aged [15][16][17][18][19][20][21][22][23][24] were at risk of this disease more than others. This disease has no symptom.…”

Section: Endometriosismentioning

confidence: 99%

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Infertility-Related Risk Factors: A Systematic Review

Deyhoul¹,

Mohamaddoost²,

Hosseini³

2017

IJWHR

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IntroductionOxford English Dictionary defines the word "infertile" or barren as "inability to give birth or procreate. " This definition refers to the "sterilization mode rather than visualization difficulty" and presents so many clinical perspectives (1). According to the reports of the International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO), "infertility" is a couple's failure in pregnancy after 12 months of unprotected sexual intercourse and pregnancy attempts. Infertility is a global problem affecting people around the world whose cause and importance may vary according to the geographical location and socio-economic condition. According to the statistics, annually 60-80 million couples around the world suffer from infertility (2). The estimated fertility rate in Canada is 11.5% to 15.7%. One out of seven English couples suffers from fertility problems (3). The number of couples affected by infertility has increased from 42.0 million people (39.6 million people, 44.8 million people) in 1990 to 48.5 million people (45.0 million people, 52.6 million people) in 2010 (4). Ten to 12% of couples around the world are suffering from infertility in half of which, the man is infertile. The estimates show that in 35%-40% of cases, the man is infertile and in 35%-40% of cases, the woman is infertile and in 20%-30% of cases, it is related to the combination of other factors (5). Infertility occurs once pregnancies are ended up with abortion (ASR) or the delivery of a child with multiple hereditary diseases (6). Infertility diagnosis is different and may include the evaluation of sperm quality; Mormons, and analysis of imaging of uterus and fallopian tubes. According to the medical diagnosis, infertility may be treated by reproductive surgery, prescribing hormones or applying infertility technologies (2). Infertility awareness, like men and women's awareness of risk factors, is the first step in protecting pregnancy in lifestyle modification. Knowledge and awareness of fertility depends on education rather than personal fertility or motherhood and fatherhood experience. Health improving strategies started with educational interventions (3). Secondary infertility refers to a state in which pregnancy does not occur after one year (in some epidemiologic studies 2 years) of unprotected sexual intercourse despite at least one pregnancy in the past. Women with secondary infertility cannot give birth to alive child (7). Infertility may result from a wide range of abnormalities one or both of which exist. However, infertility is not much different in people and it can have a variety of causes (8). The primary and secondary causes of infertility are reviewed in this study. This study examines the following points: primary causes of infertility, such as genetic factors, hormonal disorders, genetic disorders, congenital defects or reproductive system diseases; secondary factors, including lifestyle related factors, such as obesity, diet, smoking, alcohol consumption an...

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Section: Endometriosismentioning

confidence: 99%

“…Natural killer cells play an important role in female sexual function. This cells are correlated with inductive failures, NK cell cytotoxicity induced abortion or infertility and gene expression (18).…”

mentioning

confidence: 99%

Infertility-Related Risk Factors: A Systematic Review

Deyhoul¹,

Mohamaddoost²,

Hosseini³

2017

IJWHR

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“…The immune system of the mother is tightly controlled to defend against microbial infections, but to accept the embryo, which expresses semiallogenic paternal antigens through its development. It is likely that mechanisms have developed to prevent immune rejection of the embryo including local and systemic immune responses involving immunoglobulins, cytokines, hormonal and other endometrial factors, and only when several mechanisms fail in a woman RM will occur [13,15,60].…”

Section: Managementmentioning

confidence: 99%

“…The most abundant immune cells in the uterine decidua around the time of implantation and early placental development are the uNK cells. Altered numbers of uNK cells have been associated with several human reproductive disorders, including RM [14,46,60].…”

Section: Managementmentioning

confidence: 99%

Recurrent Miscarriage: A Review

Barrenetxea¹

2017

RMGO

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pregnancy events [2]. Clinical miscarriages may be subdivided into early clinical pregnancy losses (before gestational week 12) and late clinical pregnancy losses (gestational weeks 12 to 21). The term miscarriage is preferred rather than abortion both by patients and physicians, although "spontaneous abortion" is still used in scientific literature [3,4].For more than 30 years, controversy has existed on the number of miscarriages required to define RM and when diagnostic testing is warranted [5] EpidemiologyEarly pregnancy loss is perhaps the most common obstetric complication, occurring in over two-thirds of human conceptions. Approximately 15 -20% of all clinically recognized pregnancies will end in a miscarriage [4,9,10]. However, prospective cohort studies using sensitive and specific daily urinary hCG assays in women trying to conceive have demonstrated that only around one-third of conceptions progress to a live birth. Most of the losses occur before the clinical recognition of pregnancy as implantation failures. An estimated 30% of human conceptions are lost prior to implantation and a further 30% following implantation but before the missed menstrual period, that is in the third or fourth week of gestation. These are often termed preclinical losses [11].The risk of sporadic miscarriage between 6 and 12 weeks of gestation in women less than 35 years of age is 9% to 12%. The risk increases with age. In women older than 40 years of age, the sporadic miscarriage rate approaches 50%. Late losses between 12 and 22 weeks occur less frequently and constitute around 4% of pregnancy outcomes [4,9].Compared to sporadic miscarriage the prevalence of RM is considerably lower irrespective of whether biochemical losses are included or not. Approximately 1% of all women trying to conceive have recurrent miscarriage, defined as three previous miscarriages; when recurrent miscarriage is defined as two previous miscarriages, the proportion rises to 3% [12,13]. EtiologyMultiple potential etiologies for RM have been described (Table 1). As a consequence, several recommendations have been published regarding the evaluation and management of RM [3].The potential etiologies of RM can be divided into embryologically driven causes (mainly due to an abnormal embryonic karyotype) and maternally driven causes which affect the endometrium and/or placental development [14,15]. Thus, studies that focus on RM have Barrenetxea G, et al., J Reprod Med Gynecol Obstet 2017 AbstractHuman reproduction is characterized by its inefficiency. The loss of pregnancy at any stage can be a devastating experience and particular sensitivity is required in assessing and counseling couples with Recurrent Miscarriage (RM). Recurrent Miscarriage (RM) represents a clinical challenge for physicians not only because there are multiple possible etiologies, but also because the diagnostic testing is costly and time consuming. Despite several well-known etiologic factors, the cause of RM cannot be determined in almost 50% of cases. Multiple potential etiolo...

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“…They are essential for trophoblastic migration and invasion, changing character and cytokine expression during the menstrual cycle. They can secrete IFN-γ to induce local angiogenesis and spiral artery formation [42,44,45]. However, when activated by HLA-G or HLA-C, they can lead to defective proliferation and invasion of the feto-maternal surface [45][46][47][48][49][50][51][52][53].…”

Section: Natural Killer Cellsmentioning

confidence: 99%

Immunogenetic contributions to recurrent pregnancy loss

Grimstad

Krieg

2016

J Assist Reprod Genet

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While sporadic pregnancy loss is common, occurring in 15 % of pregnancies, recurrent pregnancy loss (RPL) impacts approximately 5 % of couples. Though multiple causes are known (including structural, hormonal, infectious, autoimmune, and thrombophilic causes), after evaluation, roughly half of all cases remain unexplained. The idiopathic RPL cases pose a challenging therapeutic dilemma in addition to incurring much physical and emotional morbidity. Immunogenetic causes have been postulated to contribute to these cases of RPL. Natural Killer cell, T cell expression pattern changes in the endometrium have both been shown in patients with RPL. Human leukocyte antigen (HLA) and cytokine allelic variations have also been studied as etiologies for RPL. Some of the results have been promising, however the studies are small and have not yet put forth outcomes that would change our current diagnosis and management of RPL. Larger database studies are needed with stricter control criteria before reasonable conclusions can be drawn.

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Natural killer cells in female infertility and recurrent miscarriage: a systematic review and meta-analysis

Cited by 249 publications

References 64 publications

Infertility-Related Risk Factors: A Systematic Review

Infertility-Related Risk Factors: A Systematic Review

Recurrent Miscarriage: A Review

Immunogenetic contributions to recurrent pregnancy loss

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