title: Some aspects of interactivity between endocrine and immune systems required for successful reproduction.
abstract: BACKGROUND
  In 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.
  
  
  METHODS
  In 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.
  
  
  RESULTS
  No 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).
  
  
  CONCLUSIONS
  Association 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.
authors.affiliation: Center for Human Reproduction, New York, NY, USA. andrea.weghofer@meduniwien.ac.at.|Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria. andrea.weghofer@meduniwien.ac.at.
authors.forename: Andrea
authors.initials: A
authors.lastname: Weghofer
authors.affiliation: Center for Human Reproduction, New York, NY, USA. ehimaya@gmail.com.|Centre Hospitalier de l'Université de Montréal, Montreal, Canada. ehimaya@gmail.com.
authors.forename: Eric
authors.initials: E
authors.lastname: Himaya
authors.affiliation: Center for Human Reproduction, New York, NY, USA. vkushnir@thechr.com.
authors.forename: Vitaly A
authors.initials: VA
authors.lastname: Kushnir
authors.affiliation: Center for Human Reproduction, New York, NY, USA. dbarad@thechr.com.|Foundation for Reproductive Medicine, New York, NY, USA. dbarad@thechr.com.
authors.forename: David H
authors.initials: DH
authors.lastname: Barad
authors.affiliation: Center for Human Reproduction, New York, NY, USA. elazzaroni@thechr.com.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Lazzaroni-Tealdi
authors.affiliation: Center for Human Reproduction, New York, NY, USA. yyu@thechr.com.
authors.forename: Yao
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Center for Human Reproduction, New York, NY, USA. ywu@thechr.com.
authors.forename: Yan-Guang
authors.initials: YG
authors.lastname: Wu
authors.affiliation: Center for Human Reproduction, New York, NY, USA. ngleicher@thechr.com.|Foundation for Reproductive Medicine, New York, NY, USA. ngleicher@thechr.com.
authors.forename: Norbert
authors.initials: N
authors.lastname: Gleicher
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood; D015331:Cohort Studies; D004622:Embryo, Mammalian / Q000502:physiology; D004703:Endocrine System / Q000502:physiology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007107:Immune System / Q000502:physiology*; D055633:Immune System Phenomena; D007247:Infertility, Female / Q000276:immunology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012098:Reproduction / Q000276:immunology*
chemical_list: D000728:Androgens