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[The relationship between inflammatory and immunological processes during pregnancy. Practical aspects].

Vilmos Fülöp1,2, Gábor Vermes1, János Demeter1

  • 1Magyar Honvédség Egészségügyi Központ, Szülészeti-nőgyógyászati Osztály, Semmelweis Egyetem Gyakorló Kórház Budapest, Podmaniczky u. 111., 1062.

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Summary

Implantation failure affects 75% of unsuccessful pregnancies and limits in vitro fertilization success. Understanding the role of inflammation and progesterone is key to improving care for infertile couples.

Keywords:
beágyazódásimmune toleranceimmuntoleranciaimplantationprogesteroneprogeszteron“good” inflammation„jó” gyulladás

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Area of Science:

  • Reproductive Medicine
  • Immunology
  • Obstetrics

Background:

  • Implantation failure is a major cause of pregnancy loss and limits in vitro fertilization (IVF) success.
  • Pregnancy involves a delicate balance between inflammation, crucial for implantation and parturition, and immune tolerance to prevent rejection of the semi-allograft fetus.
  • Progesterone plays a vital role in maintaining immune tolerance and a non-inflammatory state during most of pregnancy.

Purpose of the Study:

  • To review the biological basis of implantation and pregnancy maintenance.
  • To explore novel therapeutic strategies for reproductive clinicians to enhance care for infertile couples.
  • To understand the dynamic role of inflammation throughout gestation.

Main Methods:

  • Literature review of immunological and hormonal factors in human pregnancy.
  • Analysis of the inflammatory processes during implantation and their regulation.
  • Examination of the role of progesterone in immune tolerance and pregnancy maintenance.

Main Results:

  • A "good" inflammatory response is essential for successful implantation and birth.
  • Progesterone withdrawal after 36 weeks reduces immune suppression, leading to "good" inflammation, cervical ripening, and parturition.
  • Failure to establish or maintain immune tolerance, often linked to implantation issues, contributes to pregnancy complications.

Conclusions:

  • Optimizing the understanding and management of inflammation and progesterone signaling can improve outcomes for infertile couples.
  • Targeting the inflammatory balance may offer new therapeutic avenues for recurrent implantation failure and IVF.
  • Further research into maternal-fetal immune interactions is crucial for advancing reproductive medicine.