Immunological tests and therapies in reproductive medicine.
Immunology plays a crucial role in establishing successful pregnancy. This is primarily due the recognition of fetal antigen and alteration of the immune response mounted by the mother. It is therefore easy to understand the importance of testing for immune causes of reproductive failure and offer immune therapy to those with abnormal immune response. The main difficulty with this model is the understanding of what is normal, which is still under study, and then to test for abnormality. It is only after these two questions are answered that we can consider the use of immunotherapy in women with immune causes of reproductive failure. This review looks at the current available information on the immunology surrounding reproductive failure and the current therapies offered to rectify these abnormalities. Till date numerous studies have looked into the role of various immune suppressant modulatory therapies in women with recurrent miscarriage or implantation failure after assisted conception and have suggested that there is a place for immune therapy in reproductive failure. However the search for best evidence is still on and randomized, blinded data with adequate sample size is lacking. Till such time that it becomes available, immune testing and immunotherapy should be offered within the realms of a research setting.
Prakash
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Department of Gynecology and Reproductive Medicine, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK. alkaprakash@hotmail.com
D000022:Abortion, Spontaneous / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007159:Immunologic Tests; D007167:Immunotherapy; D011247:Pregnancy