Where and when should natural killer cells be tested in women with repeated implantation failure?

Santillan, Isabel; Lozano, Ignacio Fernández; Illán, Julia; Verdú, Victoria; Coca, Santiago; Bajo-Arenas, José; Martinez, Felipe

doi:10.1016/j.jri.2014.12.009

Cited by 37 publications

(24 citation statements)

References 25 publications

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“…This allowed visualization of the uterine NK cells with immunohistochemical staining. Though cut off values still require standardization, analysis of NK cells might eventually prove to be useful to women suffering from idiopathic RIF [ 34 ]. On the other hand, a recent meta-analysis by Seshadri et al set out to determine the role of both peripheral and uterine NK cells in infertility and recurrent miscarriage and found some conflicting data regarding their role.…”

Section: Pathophysiological Mechanisms Of Recurrent Implantation Failmentioning

confidence: 99%

Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions

Bashiri

Halper

Orvieto

2018

Reprod Biol Endocrinol

413

346

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Recurrent implantation failure (RIF) refers to cases in which women have had three failed in vitro fertilization (IVF) attempts with good quality embryos. The definition should also take advanced maternal age and embryo stage into consideration. The failure of embryo implantation can be a consequence of uterine, male, or embryo factors, or the specific type of IVF protocol. These cases should be investigated to determine the most likely etiologies of the condition, as this is a complex problem with several variables. There are multiple risk factors for recurrent implantation failure including advanced maternal age, smoking status of both parents, elevated body mass index, and stress levels. Immunological factors such as cytokine levels and presence of specific autoantibodies should be examined, as well as any infectious organisms in the uterus leading to chronic endometritis. Uterine pathologies such as polyps and myomas as well as congenital anatomical anomalies should be ruled out. Sperm analysis, pre-implantation genetic screening and endometrial receptivity should be considered and evaluated, and IVF protocols should be tailored to specific patients or patient populations. Treatment approaches should be directed toward individual patient cases. In addition, we suggest considering a new initial step in approach to patients with RIF, individualized planned activities to activate the brain's reward system in attempt to improve immunological balance in the body.

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Section: Pathophysiological Mechanisms Of Recurrent Implantation Failmentioning

confidence: 99%

Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions

Bashiri

Halper

Orvieto

2018

Reprod Biol Endocrinol

413

346

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“…Evidence would appear to suggest that women with unexplained implantation failure may have an abnormal population of natural killer (NK) cells in the blood and in the endometrium in the mid-luteal phase of the menstrual cycle (293), although strategies to improve the systemic and endometrial environment to facilitate conception have not been proven (305).…”

Section: Natural Killer Cellsmentioning

confidence: 99%

Physiological Aspects of Female Fertility: Role of the Environment, Modern Lifestyle, and Genetics

Hart

2016

Physiological Reviews

173

119

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Across the Western World there is an increasing trend to postpone childbearing. Consequently, the negative influence of age on oocyte quality may lead to a difficulty in conceiving for many couples. Furthermore, lifestyle factors may exacerbate a couple's difficulty in conceiving due mainly to the metabolic influence of obesity; however, the negative impacts of low peripheral body fat, excessive exercise, the increasing prevalence of sexually transmitted diseases, and smoking all have significant negative effects on fertility. Other factors that impede conception are the perceived increasing prevalence of the polycystic ovary syndrome, which is further exacerbated by obesity, and the presence of uterine fibroids and endometriosis (a progressive pelvic inflammatory disorder) which are more prevalent in older women. A tendency for an earlier sexual debut and to have more sexual partners has led to an increase in sexually transmitted diseases. In addition, there are several genetic influences that may limit the number of oocytes within the ovary; consequently, by postponing attempts at childbearing, a limitation of oocyte number may become evident, whereas in previous generations with earlier conception this potentially reduced reproductive life span did not manifest in infertility. Environmental influences on reproduction are under increasing scrutiny. Although firm evidence is lacking however, dioxin exposure may be linked to endometriosis, phthalate exposure may influence ovarian reserve, and bisphenol A may interfere with oocyte development and maturation. However, chemotherapy or radiotherapy is recognized to lead to ovarian damage and predispose the woman to ovarian failure.

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“…It has been previously reported that increased numbers and activity of peripheral NK cells are associated with a negative pregnancy outcome (biochemical pregnancy or miscarriage) (Yamada et al, 2003). To the same direction, a parallel increase in peripheral and uterine NK cell numbers and NK activity was found in women diagnosed as RIF (Santillán et al, 2015). However, the role of the NK cells in human reproduction is quite complex; NK cells constitute a rather diverse cellular population making the discrimination between peripheral and uterine NK cells rather difficult.…”

Section: Immunological Disordersmentioning

confidence: 71%

Approaches to Improve Endometrial Receptivity in Case of Repeated Implantation Failures

Makrigiannakis

Makrygiannakis

Vrekoussis

2021

Front. Cell Dev. Biol.

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Repeated implantation failures are a constant challenge in reproductive medicine with a significant impact both on health providers and on infertile couples. Several approaches have been proposed so far as effective; however, accumulative data have clarified that most of the treatment options do not have the evidence base for a generalized application to be suggested by the relevant societies. Implantation failures are attributed to either poor quality embryos or to defected endometrial receptivity. The current review aims to summarize in a systematic way all the new trends in managing RIF via interference with endometrial receptivity. The authors focus mainly, but not exclusively, on endometrial injury prior to embryo transfer and endometrial priming with autologous cells or biological agents. To this direction, a systematic search of the Pubmed database has been conducted taking into account the emerged evidence of the last two decades. All the suggested interventions are herein presented and analyzed in terms of reproductive outcomes. It is evident that properly powered and designed randomized trials are needed to support a new standard approach in RIF treatment that will safely be incorporated in national and international guidelines.

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Where and when should natural killer cells be tested in women with repeated implantation failure?

Cited by 37 publications

References 25 publications

Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions

Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions

Physiological Aspects of Female Fertility: Role of the Environment, Modern Lifestyle, and Genetics

Approaches to Improve Endometrial Receptivity in Case of Repeated Implantation Failures

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