Descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomes
Introduction Reproductive immunology has advanced significantly, recognizing the immune system as crucial in pregnancy development and facilitating the identification of abnormalities causing recurrent reproductive failure, as well as proposing targeted treatments for these patients. Methods This...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Medwave Estudios Limitada
2025-06-01
|
| Series: | Medwave |
| Subjects: | |
| Online Access: | https://www.medwave.cl/investigacion/estudios/3037.html |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850095028286783488 |
|---|---|
| author | Eduardo de la Fuente-Muñoz Nabil Subhi-Issa Ángela Villegas Mendiola Juliana Ochoa-Grullón Kissy Guevara-Hoyer Raquel Gil-Laborda Lydia Pilar-Suárez María Dolores Mansilla Ruíz María Pilar Gasca Escorial Teresa Gastañaga-Holguera Marta Calvo Urrutia María Guzmán Fulgencio Natalia Rodríguez Vicente Miguel Fernández-Arquero Ignacio Cristóbal García Silvia Sánchez-Ramón |
| author_facet | Eduardo de la Fuente-Muñoz Nabil Subhi-Issa Ángela Villegas Mendiola Juliana Ochoa-Grullón Kissy Guevara-Hoyer Raquel Gil-Laborda Lydia Pilar-Suárez María Dolores Mansilla Ruíz María Pilar Gasca Escorial Teresa Gastañaga-Holguera Marta Calvo Urrutia María Guzmán Fulgencio Natalia Rodríguez Vicente Miguel Fernández-Arquero Ignacio Cristóbal García Silvia Sánchez-Ramón |
| author_sort | Eduardo de la Fuente-Muñoz |
| collection | DOAJ |
| description | Introduction Reproductive immunology has advanced significantly, recognizing the immune system as crucial in pregnancy development and facilitating the identification of abnormalities causing recurrent reproductive failure, as well as proposing targeted treatments for these patients.
Methods This is a descriptive, observational, and retrospective study conducted at the Reproductive Immunology Unit of the Hospital Clínico San Carlos in Madrid. Clinical and analytical data were analyzed for patients diagnosed with recurrent reproductive failure between 2019 and 2023. Data on treatments received as prophylaxis for pregnancy loss and their success rates were also collected. Finally, a comparative study of the two major subgroups in the cohort was performed.
Results A total of 277 patients were included. The most prevalent diagnosis was recurrent miscarriage (64.2%), followed by recurrent implantation failure (25.2%). Immunological and/or vascular abnormalities were detected in 88.8% of patients. The most prevalent immunological abnormality was the expansion of cytotoxic natural killer cells (49.5%), followed by HLA-C-KIR mismatch (39.1%) and the presence of antiphospholipid antibodies (38.5%). The comparative study between the recurrent miscarriage and the recurrent implantation failure subgroups revealed statistically significant differences regarding the presence of antinuclear antibodies (15.4% vs. 28.3%, p=0.03) and vitamin D deficiency (37.2 vs 60.0%, p=0.01). The most commonly used medications were low-dose acetylsalicylic acid, low-molecular-weight heparin, hydroxychloroquine, and/or prednisone, with an overall success rate of 97.3%. Neither moderate nor severe side effects were reported.
Conclusions Immunological studies to identify causes of recurrent reproductive failure are highly useful in cases where other etiologies have been excluded. Targeted therapies for addressing these abnormalities have demonstrated significant effectiveness. |
| format | Article |
| id | doaj-art-c4f4ff4a80d4431784c714689d694f47 |
| institution | DOAJ |
| issn | 0717-6384 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Medwave Estudios Limitada |
| record_format | Article |
| series | Medwave |
| spelling | doaj-art-c4f4ff4a80d4431784c714689d694f472025-08-20T02:41:31ZengMedwave Estudios LimitadaMedwave0717-63842025-06-012505e3037e303710.5867/medwave.2025.05.3037Descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomesEduardo de la Fuente-Muñoz0https://orcid.org/0000-0001-8419-679XNabil Subhi-Issa1https://orcid.org/0000-0002-0654-7934Ángela Villegas Mendiola2https://orcid.org/0009-0008-4394-5465Juliana Ochoa-Grullón3https://orcid.org/0000-0002-5218-7108Kissy Guevara-Hoyer4https://orcid.org/0000-0003-3568-8821Raquel Gil-Laborda5https://orcid.org/0000-0002-8689-3019Lydia Pilar-Suárez6https://orcid.org/0000-0002-0278-6479María Dolores Mansilla Ruíz7https://orcid.org/0009-0000-1304-4561María Pilar Gasca Escorial8Teresa Gastañaga-Holguera9https://orcid.org/0000-0002-7130-0137Marta Calvo Urrutia10María Guzmán Fulgencio11Natalia Rodríguez Vicente12https://orcid.org/0000-0001-5130-5718Miguel Fernández-Arquero13https://orcid.org/0009-0007-6213-6789Ignacio Cristóbal García14https://orcid.org/0000-0002-2793-6592Silvia Sánchez-Ramón15https://orcid.org/0000-0001-9585-6167Servicio Inmunología, Hospital Clínico San Carlos, Madrid, España; Departamento Inmunología, ORL y Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, España; Departamento Inmunología, ORL y Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, España; Departamento Inmunología, ORL y Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, España; Departamento Inmunología, ORL y Oftalmología, Facultad de Medicina,Servicio de Obstetricia y Ginecología, Hospital Clínico San Carlos, Madrid, España Servicio Inmunología, Hospital Clínico San Carlos, Madrid, EspañaServicio de Obstetricia y Ginecología, Hospital Clínico San Carlos, Madrid, EspañaServicio de Obstetricia y Ginecología, Hospital Clínico San Carlos, Madrid, EspañaServicio de Obstetricia y Ginecología, Hospital Clínico San Carlos, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, España; Departamento Inmunología, ORL y Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, España; Servicio de Obstetricia y Ginecología, Hospital Clínico San Carlos, Madrid, EspañaServicio Inmunología, Hospital Clínico San Carlos, Madrid, España; Departamento Inmunología, ORL y Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España.Introduction Reproductive immunology has advanced significantly, recognizing the immune system as crucial in pregnancy development and facilitating the identification of abnormalities causing recurrent reproductive failure, as well as proposing targeted treatments for these patients. Methods This is a descriptive, observational, and retrospective study conducted at the Reproductive Immunology Unit of the Hospital Clínico San Carlos in Madrid. Clinical and analytical data were analyzed for patients diagnosed with recurrent reproductive failure between 2019 and 2023. Data on treatments received as prophylaxis for pregnancy loss and their success rates were also collected. Finally, a comparative study of the two major subgroups in the cohort was performed. Results A total of 277 patients were included. The most prevalent diagnosis was recurrent miscarriage (64.2%), followed by recurrent implantation failure (25.2%). Immunological and/or vascular abnormalities were detected in 88.8% of patients. The most prevalent immunological abnormality was the expansion of cytotoxic natural killer cells (49.5%), followed by HLA-C-KIR mismatch (39.1%) and the presence of antiphospholipid antibodies (38.5%). The comparative study between the recurrent miscarriage and the recurrent implantation failure subgroups revealed statistically significant differences regarding the presence of antinuclear antibodies (15.4% vs. 28.3%, p=0.03) and vitamin D deficiency (37.2 vs 60.0%, p=0.01). The most commonly used medications were low-dose acetylsalicylic acid, low-molecular-weight heparin, hydroxychloroquine, and/or prednisone, with an overall success rate of 97.3%. Neither moderate nor severe side effects were reported. Conclusions Immunological studies to identify causes of recurrent reproductive failure are highly useful in cases where other etiologies have been excluded. Targeted therapies for addressing these abnormalities have demonstrated significant effectiveness.https://www.medwave.cl/investigacion/estudios/3037.htmlrecurrent miscarriageinfertility femalereproductive medicineantiphospholipid syndromeautoimmunity |
| spellingShingle | Eduardo de la Fuente-Muñoz Nabil Subhi-Issa Ángela Villegas Mendiola Juliana Ochoa-Grullón Kissy Guevara-Hoyer Raquel Gil-Laborda Lydia Pilar-Suárez María Dolores Mansilla Ruíz María Pilar Gasca Escorial Teresa Gastañaga-Holguera Marta Calvo Urrutia María Guzmán Fulgencio Natalia Rodríguez Vicente Miguel Fernández-Arquero Ignacio Cristóbal García Silvia Sánchez-Ramón Descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomes Medwave recurrent miscarriage infertility female reproductive medicine antiphospholipid syndrome autoimmunity |
| title | Descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomes |
| title_full | Descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomes |
| title_fullStr | Descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomes |
| title_full_unstemmed | Descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomes |
| title_short | Descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomes |
| title_sort | descriptive analysis of immunological abnormalities in recurrent reproductive failure and therapeutical outcomes |
| topic | recurrent miscarriage infertility female reproductive medicine antiphospholipid syndrome autoimmunity |
| url | https://www.medwave.cl/investigacion/estudios/3037.html |
| work_keys_str_mv | AT eduardodelafuentemunoz descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT nabilsubhiissa descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT angelavillegasmendiola descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT julianaochoagrullon descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT kissyguevarahoyer descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT raquelgillaborda descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT lydiapilarsuarez descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT mariadoloresmansillaruiz descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT mariapilargascaescorial descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT teresagastanagaholguera descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT martacalvourrutia descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT mariaguzmanfulgencio descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT nataliarodriguezvicente descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT miguelfernandezarquero descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT ignaciocristobalgarcia descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes AT silviasanchezramon descriptiveanalysisofimmunologicalabnormalitiesinrecurrentreproductivefailureandtherapeuticaloutcomes |