Clinical rheumatologic applications of reproductive immunology. Facts, fiction, and fancy
✍ Scribed by Daniel J. Wallace; Maurice L. Druzin; Robert G. Lahita
- Book ID
- 102754728
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 860 KB
- Volume
- 40
- Category
- Article
- ISSN
- 0004-3591
No coin nor oath required. For personal study only.
✦ Synopsis
Efforts by couples to fulfill a woman's biologic prerogative to procreate can have strange twists which may carry rheumatologic implications. Even though 85% of all pregnancies are successful, many couples experience 2 or more consecutive pregnancy losses, and still others are not able to conceive at all. The reasons for pregnancy loss include infection, abnormal fetal anatomy, abnormal uterine anatomy, low progesterone levels, abnormal chromosomes, and immune mechanisms. Explorations into the latter aspect have spawned a new discipline known as "reproductive immunology." This discipline involves basic and clinical scientists who study fundamental issues, such as mechanisms of tolerance, regulation of gene expression at the maternal-fetal interface, and immunity in the male and female reproductive tracts. Within this group are "fertility immunologists," whose credentials run the gamut from being trained in obstetricsigynecology, allergy/immunology, or rheumatology to general practice.
We have observed a trend whereby some fertility specialists (most of whom are reproductive endocrinologists) are referring difficult cases, especially those involving multiple miscarriages in patients with autoantibodies, to fertility immunologists. At first glance, this appears commendable, but over the last few years, we have become aware of increasing instances in which ~-~