Recurrent pregnancy loss: An outcome of cytokine breach at
materno-embryonic interface
Abstract
Abstract: Recurrent pregnancy loss (RPL) is a prominent reproductive
disease that distresses about 2%-5% of couples. RPL is the loss of two
or more successive spontaneous pregnancies prior to 20th week of the
embryo development. The commencement of pregnancy necessitates
implantation of the embryo into responsive maternal decidua synchronized
with the process of placentation, decidual and myometrial trophoblast
incursion as well as refashioning of spiral blood arteries of uterus.
The collapse of any of the processes fundamental for accomplishment of
pregnancy may result into an array of pregnancy problems including
spontaneous pregnancy loss. Human female with normally working immune
system may well carry a partly-allogenic embryo to full tenure with no
apparent rejection via adjustment of the immune system so as to accept
and tolerate the embryo. The endometrium of human female manufactures an
extensive range of cytokines during the proliferative and secretory
stage of menstrual cycle. These endometrial cytokines are thought as
major players for making the uterus ready for embryo implantation and
placental development. Decidual cytokines regulate the invasion of
trophoblast and remodeling of spiral arteries as well as take part in
immune suppression to accomplish the pregnancy. Deterrence of fetal
dismissal by the mother needs a regulated milieu, which takes place
essentially at the embryo-maternal interface and the tissues of uterus.
The reasons of RPL remain anonymous in a large number of cases that
leads to difficulties in management and severe trauma in couples.
Further study of novel factors is wanted to establish treatment
protocols for RPL.