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Recurrent pregnancy loss: An outcome of cytokine breach at materno-embryonic interface
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  • Shafat Ali,
  • Sabhiya Majid,
  • Md. AlI,
  • Shahnaz Taing,
  • Muneeb Rehman
Shafat Ali
University of Kashmir
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Sabhiya Majid
Government Medical College Srinagar
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Md. AlI
University of Kashmir
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Shahnaz Taing
Government Medical College Srinagar
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Muneeb Rehman
King Saud University
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Abstract

Abstract: Recurrent pregnancy loss (RPL) is a prominent reproductive disease that distresses about 2%-5% of couples. RPL is the loss of two or more successive spontaneous pregnancies prior to 20th week of the embryo development. The commencement of pregnancy necessitates implantation of the embryo into responsive maternal decidua synchronized with the process of placentation, decidual and myometrial trophoblast incursion as well as refashioning of spiral blood arteries of uterus. The collapse of any of the processes fundamental for accomplishment of pregnancy may result into an array of pregnancy problems including spontaneous pregnancy loss. Human female with normally working immune system may well carry a partly-allogenic embryo to full tenure with no apparent rejection via adjustment of the immune system so as to accept and tolerate the embryo. The endometrium of human female manufactures an extensive range of cytokines during the proliferative and secretory stage of menstrual cycle. These endometrial cytokines are thought as major players for making the uterus ready for embryo implantation and placental development. Decidual cytokines regulate the invasion of trophoblast and remodeling of spiral arteries as well as take part in immune suppression to accomplish the pregnancy. Deterrence of fetal dismissal by the mother needs a regulated milieu, which takes place essentially at the embryo-maternal interface and the tissues of uterus. The reasons of RPL remain anonymous in a large number of cases that leads to difficulties in management and severe trauma in couples. Further study of novel factors is wanted to establish treatment protocols for RPL.