Immunogenetic contributions to recurrent pregnancy loss

J Assist Reprod Genet. 2016 Jul;33(7):833-47. doi: 10.1007/s10815-016-0720-6. Epub 2016 May 12.

Abstract

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.

Keywords: HY-Antibodies; Human leukocyte antigens; Immunogenetics; Recurrent pregnancy loss; T regulatory cell.

Publication types

  • Review

MeSH terms

  • Abortion, Habitual / genetics*
  • Abortion, Habitual / immunology*
  • Abortion, Habitual / pathology
  • Cytokines / immunology
  • Endometrium / cytology*
  • Endometrium / immunology
  • Female
  • HLA Antigens / genetics
  • HLA Antigens / immunology*
  • Humans
  • Immunogenetics
  • Killer Cells, Natural / immunology*
  • Ovary / pathology
  • T-Lymphocytes / immunology*
  • Uterus / pathology

Substances

  • Cytokines
  • HLA Antigens