Some aspects of interactivity between endocrine and immune systems required for successful reproduction

Abstract

BackgroundIn successful reproduction, endocrine and immune systems closely interact. We here attempt to further elucidate the relationship between androgen levels, systemic activation of the immune system and reproductive success in infertile women, utilizing 2 distinct infertile patient cohorts.MethodsIn Group 1, we investigated 322 women (ages 38.6 +/− 5.4 years) at initial presentation; in Group 2 125 women undergoing in vitro fertilization (169 IVF cycles, ages 38.9 +/− 5.5 years). In Group 1, we assessed androgens and an immune panel, previously demonstrated to discriminate between activated quiescent immune systems; in Group 2, utilizing the same immune panel, we investigated whether immune system activation relates to embryo quality in IVF cycles.ResultsNo individual immune test within the immune panel was associated with androgen levels. The total/free testosterone ratio (TT/FT) was, however, significantly associated with presence of gammopathies (in IgG, IgM, IgA, IgE; P = 0.026). Surprisingly, immune system activation was associated with significantly improved embryo quality (P = 0.008), a finding persistent after adjustment for age and repeat IVF cycles (P = 0.006).ConclusionsAssociation of immune system activation with improved embryo quality concurs with previously reported immune activation in association with normal functional ovarian reserve (FOR) and normal androgen levels, while, counter intuitively, hypoandrogenism and low FOR are associated with lack of immune system activation. Mild immune system activation, therefore, likely appears essential for establishment of pregnancy, and may be regulated by androgens.

Innate Immune System at the Maternal–Fetal Interface: Mechanisms of Disease and Targets of Therapy in Pregnancy Syndromes

“…1,2 The integration and the balance of immune factors lead to an environment that enables the fetus to escape rejection by the maternal immune system. [3][4][5][6] Innate immune responses against microorganisms at the maternal-fetal interface may have a significant impact on the success of pregnancy, as intrauterine infections have been shown to be strongly associated with certain complications of pregnancy. [7][8][9] It has been reported that immune disturbance may be responsible for some adverse pregnancy outcomes such as preeclampsia (PE), hemolysis-elevated liver enzymes-low platelets (HELLP) syndrome, recurrent spontaneous abortion (RSA), and intrauterine growth restriction (IUGR) 5,6,10-13 (Fig.…”

Expression of Insulin-Like Growth Factor Binding Protein-3 in HELLP Syndrome

“…[26], [27]Etiology research on HELLP syndrome has focused on genetics, immunology, oxidative stress, and lipid metabolism, as well as other aspects.Also, the role of the excessive inflammatory response caused by inappropriate activation of certain cytokines in pathogenesis should not be ignored. [28]- [29][30] [31][32] [33][34] [35] [36][37] [38] [39][40] [41] A variety of factors, such as ischemia and hypoxia, may upset the balance of the maternal body during pregnancy, leading to inappropriate activation of relevant cytokines and resulting in endothelial dysfunction and a series of pathophysiological changes.These factors may be crucial in the progression of HELLP syndrome.…”