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Immunogenetic contributions to recurrent pregnancy loss

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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.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Kansas, 3901 Rainbow Blvd MS 2028, Kansas City, KS, 66160, USA

    Frances Grimstad

  2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, OR, USA

    Sacha Krieg

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  1. Frances Grimstad
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  2. Sacha Krieg
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Correspondence to Frances Grimstad.

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Immunogenetic causes of recurrent pregnancy loss are promising areas of research that with further study could lead to improved diagnostic and treatment modalities.

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Grimstad, F., Krieg, S. Immunogenetic contributions to recurrent pregnancy loss. J Assist Reprod Genet 33, 833–847 (2016). https://doi.org/10.1007/s10815-016-0720-6

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  • DOI: https://doi.org/10.1007/s10815-016-0720-6

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