title: Immunogenetic contributions to recurrent pregnancy loss.
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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Kansas, 3901 Rainbow Blvd MS 2028, Kansas City, KS, 66160, USA. fgrimstad@kumc.edu.
authors.forename: Frances
authors.initials: F
authors.lastname: Grimstad
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, OR, USA.
authors.forename: Sacha
authors.initials: S
authors.lastname: Krieg
mesh_terms: D000026:Abortion, Habitual / Q000235:genetics* / Q000276:immunology* / Q000473:pathology; D016207:Cytokines / Q000276:immunology; D004717:Endometrium / Q000166:cytology* / Q000276:immunology; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007125:Immunogenetics; D007694:Killer Cells, Natural / Q000276:immunology*; D010053:Ovary / Q000473:pathology; D013601:T-Lymphocytes / Q000276:immunology*; D014599:Uterus / Q000473:pathology
chemical_list: D016207:Cytokines; D006680:HLA Antigens
keywords: HY-Antibodies; Human leukocyte antigens; Immunogenetics; Recurrent pregnancy loss; T regulatory cell