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Review
. 2014 Aug;72(2):141-7.
doi: 10.1111/aji.12266. Epub 2014 May 9.

The role of inflammation for a successful implantation

Affiliations
Review

The role of inflammation for a successful implantation

Nava Dekel et al. Am J Reprod Immunol. 2014 Aug.

Abstract

Approximately half of all human embryo implantations result in failed pregnancy. Multiple factors may contribute to this failure, including genetic or metabolic abnormalities of the embryo. However, many of these spontaneous early abortion cases are attributed to poor uterine receptivity. Furthermore, although many fertility disorders have been overcome by a variety of assisted reproductive techniques, implantation remains the rate-limiting step for the success of the in vitro fertilization (IVF) treatments. We, as well as others, have demonstrated that endometrial biopsies performed either during the spontaneous, preceding cycle, or during the IVF cycle itself, significantly improve the rate of implantation, clinical pregnancies, and live births. These observations suggest that mechanical injury of the endometrium may enhance uterine receptivity by provoking the immune system to generate an inflammatory reaction. In strong support of this idea, we recently found that dendritic cells (DCs), an important cellular component of the innate immune system, play a critical role in successful implantation in a mouse model. In this review, we discuss the hypothesis that the injury-derived inflammation in the biopsy-treated patients generates a focus for uterine DCs and Mac accumulation that, in turn, enhance the endometrial expression of essential molecules that facilitate the interaction between the embryo and the uterine epithelium.

Keywords: Dendritic cells; implantation; inflammation; pregnancy.

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Figures

Figure 1
Figure 1
Dendritic Cells and Macrophages create an inflammatory gradient, which affects the epithelium to form the mucin layer and increase the expression of ligands for adhesion molecules by the blastocyst. The inflammatory gradient allows the apposition and adhesion of the blastocyst to the epithelium and promotes implantation.
Figure 2
Figure 2
Model of trophoblast-epithelium synapsis. Potential role of OPN as a bridge for CD44 on the trophoblast and integrins in the epithelium.

References

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