Opinion: Immunotherapy Has No Place in the Treatment of Recurrent Pregnancy Loss*
Howard J.A. Carp in Recurrent Pregnancy Loss, 2020
The conclusions of several published meta-analyses have also been conflicting. A Cochrane review published in 2014, based on 12 trials (641 women), reported an OR of 1.23 (95% CI 0.89–1.70) among those administered paternal white cells compared with controls [36]. It has been suggested that leucocyte immunization in the trial of Ober et al. [35] should be excluded from the meta-analysis, as Ober et al. used refrigerated cells, whereas all other trials used fresh cells. The argument against using refrigerated cells is based on work in laboratory mice (CBA/J female mice when mated with allogeneic DBA/2 males) where there is a high incidence of embryo resorption. This resorption can be prevented by immunization with paternal splenocytes. However, storage of the splenocytes causes loss of surface CD200 into the supernatant [37], which abrogates the protective effect of immunization. However, the loss of CD200 may be relevant in muridae, but has never been investigated in humans. Therefore, in this author's view, there is no justification for removing Ober et al.'s [35] trial from any meta-analysis.
The Epidemiology of Infertility
Michele Kiely in Reproductive and Perinatal Epidemiology, 2019
The spectrum of infertile couples includes some who are sterile: these may be defined as sterile because they have some condition that will predictably make pregnancy impossible, or because they remain childless at the end of their reproductive years. Most infertile couples, however, have a milder impairment in fecundity that results in only a longer than average conception delay. In addition to those with a true conception delay, there are also some apparently infertile couples who have unrecognized conceptions with early embryo loss. Several authors suggest that the most common outcome of conception is unrecognized embryo loss.12 Sterility, conception delay, and unrecognized embryo loss are each components of what is called infertility. The study of infertility is difficult because the condition includes these components which cannot usually be distinguished in retrospect and which each probably have different causes.
PGD and the making of the ‘genetic embryo' as a political tool
Sheila A.M. McLean, Sarah Elliston in Regulating Pre-Implantation Genetic Diagnosis, 2012
Some of the earliest embryo research projects supported by the MRC focused on this new third aim, including work by Angell et al.88 at the MRC’s Reproductive Biology Unit in Edinburgh. This study investigated the ‘high failure rate (80%) of implantation’ in clinical IVF, and contributed the ‘surprising and remarkable finding’ that 3/11 embryos tested showed chromosomal defects. They concluded that such defects ‘clearly result in early embryo loss’,89 and so used genetic arguments to justify the need for further research to improve the success rate of IVF. Johnson, Braude and Pratt received the first MRC external grant supporting human embryo research in 1983, which aimed ‘to draw on the knowledge of the mouse embryo to establish criteria of normal development in the human embryo, and to apply these to detect causes of abnormality and reproductive failure’.90 These individuals were heavily involved in pro-research lobbying from the mid-1980s onwards, making them well placed to publicise the potential for embryo research to facilitate detection and control of genetic disease.
Astilbin improves pregnancy outcome in rats with recurrent spontaneous abortion by regulating Th1/Th2 balance
Published in Immunopharmacology and Immunotoxicology, 2022
Ying Qian, Yue Pei, Wei Jiang, Caihong Zheng
Information on the morphology and activity of the rats was recorded every day. The female rats were sacrificed by excessive anesthesia using 10% chloral hydrate on the ninth day of pregnancy, and the numbers of surviving and reabsorbed embryos were counted. Abortion embryos were identified by the smaller size of the implantation site and the appearance of necrosis and hemorrhage. The embryo resorption rate (R) was calculated as follows: R = reabsorbed embryos/(surviving embryos + reabsorbed embryos) × 100%. The embryo absorption rate of the model group was significantly higher than that of the control group, indicating that the RSA rat model was established successfully. After the rats were sacrificed, the uteruses were removed, and the decidua of each uterus was rinsed with 0.9% normal saline while photos of uterus were taken. Sections of rat uterine tissue were coated in paraffin and stained with hematoxylin and eosin (HE). The five areas with the highest degree of endometrial molding were selected by 20-fold amplification observation. The pathological morphology of endometrial modulation was evaluated by 200-fold amplification observation.
Effects of intermediate frequency electromagnetic fields: a review of animal studies
Published in International Journal of Radiation Biology, 2023
Hae-June Lee, Hee Jin, Young Hwan Ahn, Nam Kim, Jeong Ki Pack, Hyung-Do Choi, Yun-Sil Lee
In addition to the potentially tumorigenic effects of IF-EMFs, the impact of these frequencies on early development and gestation are among the most important public concerns. Early developmental stages are known to be especially vulnerable to environmental insult. The KIRAMS thus exposed pregnant mice to IF-EMF during the organogenesis stage to investigate its effects on fetal formation. The females were exposed to a 20 kHz IF-EMF at a magnetic flux density of 6.25 μT for eight hours a day from the 2.5th to the 15.5th day of gestation. Cesarean sections were performed on the 19th day of pregnancy to observe the fetuses. The number of implantations, the number of live and dead fetuses, the sex, weight, and length of the fetuses, the length of the head, and the width and weight of the placenta were then measured. Additionally, embryo resorption, embryonic death, and fetal death were also investigated. No statistically significant differences in the number of implantations, the number of live and dead fetuses, fetus sex, and placental weight were linked to IF-EMF exposure. Additionally, the number of fetuses with growth retardation showed a weak increasing tendency in the group exposed to IF-EMF, but there was no statistical significance. The body weight and head width were not affected by IF-EMF exposure. IF-EMF exposure was also not statistically linked to external or internal malformations. Moreover, no skeletal abnormalities were observed in response to IF-EMF exposure (Lee et al. 2009).
Relationship between granulocyte–macrophage colony-stimulating factor, embryo quality, and pregnancy outcomes in women of different ages in fresh transfer cycles: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2020
Dapeng Chu, Lei Fu, Wenhui Zhou, Yuan Li
Although GM-CSF supplementation significantly increased the total available embryo rate, it did not affect pregnancy outcomes in fresh ET patients. There were no significant differences in the clinical pregnancy rate, implantation rate, biochemical pregnancy rate, or early embryo loss rate between the GM-CSF and control groups. These results are consistent with those of Shapiro et al. (2003) but different from those of Ziebe et al. (2013). In Ziebe’s study, the benefit of adding GM-CSF was apparent in culture media containing a lower concentration of 2 mg/mL HSA but not in culture media with 5 mg/mL HSA (Ziebe et al. 2013). Similarly, Sfontouris et al. (2013) found that the inclusion of GM-CSF in embryo culture media improved the pregnancy and implantation rates in patients with multiple unsuccessful IVF attempts. In the present study, the overall early embryo loss rate was relatively low, reaching only 17.5% in the control group. Together with the low concentration of GM-CSF used (0.6 ng/mL), it may help to explain the different results.
Related Knowledge Centers
- Fetus
- Organogenesis
- Embryo
- Miscarriage
- Uterus
- Pregnancy
- Animal Embryonic Development
- Prenatal Development
- Fetal Resorption
- Fertility Clinic