TNF-α, IFN-ɣ and TGF-β mRNA Expression Correlation with IVF Success Rates in Women with Recurrent Implantation Failure Undergoing Treatment with Intra-lipid infusion

Abstract

Maternal immunological modulation in pregnancy is a well-established concept, but interpretation of variations in the immune status of those attempting to conceive but appearing to have implantation failure of good quality embryos, or with recurrent pregnancy loss, is controversial. Many factors are accepted as necessary for the successful completion of an assisted reproductive technology (ART) cycle from implantation to birth. Oocyte and sperm quality along with the endometrial environment are a few examples of the hurdles which must be cleared early in the process, while maternal allograft suppression and thrombotic risk must be achieved later. The active and particularly innate immune systems are accepted components of this process and many studies link various immunological abnormalities with recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL). Auto-immune factors such as anti-phospholipid antibody syndrome and anti-thyroid peroxidase antibodies have also been shown to influence pregnancy outcome and empirical treatment in these cases is recommended. Although not standard practice, testing for immunological abnormalities in the lymphocyte populations specifically, is gaining more attention in this field. Circulating T cells, cytokine expression bias and natural killer cells are known to be fundamental to a successful pregnancy so in this regard, testing of this nature seems justified. NK cytotoxicity, for example, has been reported as being predictive of RPL. Glucocorticoid steroids have long been the agents of choice in attempts to influence the expression and activity of pro-inflammatory mediators and have been used as a key component of many proposed immunomodulatory regimens.