Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2018, Vol. 45 Issue (1): 9-13    DOI: 10.12891/ceog4381.2018
Editorial Article Previous articles | Next articles
Improving the chance of successful implantation – part 2 – Circumventing immune rejection and the fetal semi-allograft
J.H. Check1, 2, *(), J. Aly1
1 Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Cooper Medical School of Rowan University, Camden, NJ, USA
2 Cooper Institute for Reproductive and Hormonal Disorders, P.C., Mt. Laurel, NJ, USA
Download:  PDF
Export:  BibTeX | EndNote (RIS)      
Abstract  
Purpose: To review possible mechanisms of how the fetal semi-allograft avoids immune rejection. Based on these mechanisms potential therapies to improve implantation by suppressing immune rejection are discussed. Materials and Methods: Studies supporting the importance of attaining T suppressor (sup) cells to the maternal fetal interface, while decreasing TH 17 cells along with causing a shift from cellular immunity to humoral immunity by causing a shift of influence from TH1 to TH2 cytokines is presented. Also discussed is the importance of suppressing the ability of natural killer cells to attack the fetal semi-allograft related to the secretion of an immuno-immunomodulatory protein known as the progesterone induced blocking factor (PIBF). Results: Progesterone supplementation in the luteal phase, possibly by causing the production especially of intracellular PIBF, may be the most important therapy to improve embryo implantation by suppressing immune rejection. Other potential therapies include human chorionic gonadotropin (hCG) supplementation and lymphocyte immunotherapy. Conclusions: Knowledge of the mechanism by which the fetal semi-allograft escapes immune surveillance should lead to more novel therapies to improve embryo implantation.
Key words:  Progesterone      Immune surveillance      T suppressor cells      TH17 cells      Natural killer cells      Progesterone induced blocking factor     
Published:  10 February 2018     
*Corresponding Author(s):  J.H. CHECK     E-mail:  laurie@ccivf.com

Cite this article: 

J.H. Check, J. Aly. Improving the chance of successful implantation – part 2 – Circumventing immune rejection and the fetal semi-allograft. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(1): 9-13.

URL: 

https://ceog.imrpress.com/EN/10.12891/ceog4381.2018     OR     https://ceog.imrpress.com/EN/Y2018/V45/I1/9

[1] J.H. Check, A. DiAntonio, D.L. Check, M.P. Dougherty, G. Diantonio. A study to determine if estrogen (E) is needed to induce de novo progesterone (P) receptors on gamma/delta t cells as evidenced by determining the degree of rise of progesterone induced blocking factor (PIBF) following P exposure in males[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 419-420.
[2] E. Kadour-Peero, S. Khoury, J. Awad, L. Shpritz, L. Chen-Konak, C. Shechner, L. Saiegh. Determination of estradiol and progesterone concentrations in human scalp hair[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 268-271.
[3] R. Csorba, P. Tsikouras, A. Bothou, S. Zervoudis, G. Iatrakis, X. Anthoulaki, D. Deuteraiou, A. Chalkidou, G. F. von Tempelhoff. Air travel during pregnancy: an update review and practical recommendation[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 862-866.
[4] Shun Akaeda, Daiki Kobayashi, Kyoko Shioda, Mikio Momoeda. Relationship between serum progesterone concentrations and pregnancy rates in hormone replacement treatment-frozen embryo transfer using progesterone vaginal tablets[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 695-698.
[5] P. Bakas, M. Simopoulou, P. Panagopoulos, N. Salakos, Ch. Siristatidis. Luteal phase progesterone and estradiol concentrations and their relation to the outcome of IVF/ICSI cycles with controlled ovarian stimulation[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 727-730.
[6] J.H. Check, J. Liss, D. Check. The beneficial effect of luteal phase support on pregnancy rates in women with unexplained infertility[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(3): 447-449.
[7] Y. Gao, P. Wang, T. Zou, Z. Zhang, W. Liang. Increased Th17 and reduced Treg cells in patients with unexplained recurrent spontaneous abortion[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(3): 458-460.
[8] J.H. Check, M.P. Dougherty. Use of sympathomimetic amines to correct premenstrual urticaria and anaphylaxis[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(2): 309-312.
[9] J.H. Check. Pros and cons of the use of progesterone to reduce miscarriage rates[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(5): 652-655.
[10] L.E. Prado Correia, B.C. de Almeida, E. Chada Baracat, I. Silva, J.M. Soares Júnior, C.E. Bonduki, M. Abi Haidar. Efficacy and effects of transdermal hormone therapy in postmenopausal women[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(5): 735-740.
[11] J.H. Check. Intractable severe peri-ovulatory sneezing abrogated by injection of human chorionic gonadotropin[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(5): 781-781.
[12] M.B. Celtemen, P. Telli Celtemen, N. Bozkurt, C. Karakaya, S. Elberg, R.H. Gursoy. Follicular fluid anti-Müllerian hormone, inhibin-A, progesterone, and estradiol level differences in patients under controlled ovarian stimulation[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(2): 166-169.
[13] E. Djakovic, S. Rakic. Depression, anxiety, and stress after preterm delivery: role of previous progesterone therapy[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(2): 214-217.
[14] P. Bakas, M. Creatsa, P. Panagopoulos, N. Vlahos, E. Papadakis, M. Simopoulou. Outcome and recurrence risk of premature progesterone rise in IVF/ICSI cycles using GnRH antagonists for pituitary down-regulation[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(1): 44-47.
[15] J.H. Check, A. Rosenberg, D.L. Check, A. DiAntonio, H. Rui, R. Cohen, G. DiAntonio. Serum levels of the immunomodulatory protein, the progesterone induced blocking factor (PIBF) which is found in high levels during pregnancy is not higher in women with progesterone (P) receptor (R) positive vs. negative breast cancer[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(2): 187-189.
No Suggested Reading articles found!