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Implantation Failure 2: Immunomodulating Treatment for the Patients with Repeated Implantation Failures Caused by Immunological Rejection

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Treatment Strategy for Unexplained Infertility and Recurrent Miscarriage

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Abstract

Although the repeated implantation failures (RIF) in assisted reproductive technology field could cause many different reasons, the reaction that women could immunologically reject the embryos has been well known to be one of the reasons of RIF. Recently, it is reported that the balance of T-helper 1 (Th1) and T-helper 2 (Th2) has a potential to become a useful marker for detecting immunological rejection between the uterine endometrium of the infertile women and transferred embryos in ART treatment. Moreover, this ratio can be used for choosing the treatment strategy for the patients for RIF. The immunological rejection as a cause of RIF is not majority, but this cause can be solved by the appropriate approach. In this chapter, the immunomodulation treatment from the old fashion such as glucocorticoid and intravenous immunoglobulin G to the current one such as TNF-α and tacrolimus is introduced and shown how to use them. In particular, tacrolimus treatment is very useful and effective for the patients with RIF and also unexplained recurrent pregnancy loss and is safe for both mothers and fetus. The methods of using tacrolimus for the patients with RIF and RPL are interpreted in detail.

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Authors and Affiliations

  1. Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan

    Koji Nakagawa & Rikikazu Sugiyama

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  1. Koji Nakagawa
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  2. Rikikazu Sugiyama
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Correspondence to Koji Nakagawa .

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Editors and Affiliations

  1. Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan

    Keiji Kuroda

  2. Department of Obstetrics and Gynaecology, Faculty of Medicine, Juntendo University, Tokyo, Japan

    Jan J. Brosens

  3. The Division of Biomedical Sciences, Clinical Science Research Laboratories Warwick Medical School, Coventry, United Kingdom

    Siobhan Quenby

  4. Department of Obstetrics and Gynaecology, Juntendo University, Tokyo, Japan

    Satoru Takeda

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Nakagawa, K., Sugiyama, R. (2018). Implantation Failure 2: Immunomodulating Treatment for the Patients with Repeated Implantation Failures Caused by Immunological Rejection. In: Kuroda, K., Brosens, J., Quenby, S., Takeda, S. (eds) Treatment Strategy for Unexplained Infertility and Recurrent Miscarriage. Springer, Singapore. https://doi.org/10.1007/978-981-10-8690-8_5

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  • DOI: https://doi.org/10.1007/978-981-10-8690-8_5

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