Reproductive immunology: the relevance of laboratory research to clinical practice (and vice versa)

In this issue of Human Reproduction, the paper by Gu et al. represents a landmark in reproductive immunology research. A new mechanism for evasion of maternal immune attack is described, one which explains an older theory but also itself represents part of a newer understanding of the maternal – fetal relationship.

Although some of the methods may be relatively unfamiliar to many readers of this journal, the scientific en- deavour is extraordinary and it is stimulating to consider how this is placed in the context of current theory and practice of reproductive im- munology. In particular, this paper demonstrates, as an example, that there is a whole lot more to reproductive immunology than natural killer (NK) cells and immune therapy.

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Prednisolone for repeated implantation failure associated with high natural killer cell levels.

Women with unexplained repeated IVF failure present a considerable challenge. Some cases are believed to be due to immunological dysfunction preventing effective embryo implantation. As data are still being collected, doctors are faced with the dilemma of treating patients (or not) in the absence of randomised control trial evidence. This review explores a pragmatic approach in using natural killer cell analysis as a means of targeting suitable patients who might attempt treatment with additional immunosuppressive therapy.

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The distribution of immune cells and macrophages in the endometrium of women with recurrent reproductive failure. III: Further observations and reference ranges.

Abnormally functioning immunocompetent cells in the endometrium are thought to be responsible for at least some cases of recurrent reproductive failure [recurrent miscarriage or recurrent in vitro fertilisation (IVF) failure], but their detailed investigation has been hampered by a lack of a standardised protocol of counting such cells in study or control patients.

The purpose of this study is to use a standardised protocol for the assessment of immune cells in the endometrial biopsies of a large cohort of women with recurrent reproductive failure and establish relevant reference ranges.

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