• Clinical and Experimental Reproductive Medicine
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• v.47 no.2
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• pp.122-129
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• 2020

Objective: The survival of a semi-allogeneic fetus depends on several immunological mechanisms, and it has been suggested that recurrent pregnancy loss (RPL) could develop as a result of one or more immunological abnormalities. Methods: Compatibility between partners for human leukocyte antigen (HLA) genotypes and the relationships between maternal killer-cell immunoglobulin-like receptor (KIR) and paternal HLA-Bw4/Bw6 and HLA-C1/C2 supra-groups were investigated in 25 couples with RPL in comparison to healthy couples with children. HLA and KIR genotyping was performed using polymerase chain reaction with sequence-specific primers and/or sequence-specific oligonucleotides. Results: HLA class I incompatibility between partners, especially in HLA-B alleles, was more common in the RPL group (p= 0.01). HLA-C2 homozygosity was more frequent in the male partners of RPL couples than in other groups (p= 0.03). The KIR2DL5 gene frequency was significantly higher in both the female and male partners of RPL couples, whereas the KIR2DS3 gene frequency in male partners of RPL couples was significantly reduced (p= 0.03). The presence of KIR2DL3 in women with RPL was correlated with the presence of HLA-C2 alleles in their spouses (p= 0.03). Conclusion: Our data from a Turkish population suggest that male HLA-C2 homozygosity may play an important role in RPL. Additionally, an incidental match between male HLA-C2 and female HLA-C1 ligand KIR receptors might perturb the balance between activatory and inhibitory KIR-ligand interactions during pregnancy in couples affected by RPL. The roles of orphan KIR2DL5 and orphan KIR2DS3 in RPL remain obscure.

• Clinical and Experimental Reproductive Medicine
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• v.47 no.1
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• pp.68-76
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• 2020

Objective: Since sperm abnormalities are known to be a major reason for recurrent pregnancy loss (RPL), any defects in DNA structure and chromatin condensation can place embryos at risk in the early stage of development and implantation. As antioxidants such as vitamin C may play a protective role against the destruction of protamine genes in sperm chromatin, this study was conducted to evaluate the effects of vitamin C on chromatin and the expression of protamine genes in the male partners of couples with RPL. Methods: Twenty male partners of couples with RPL were selected as the intervention group and received vitamin C supplementation (250 mg daily for 3 months). Healthy fertile men (n = 20) were included as controls. Sperm chromatin, DNA integrity, and the expression levels of protamine genes were evaluated before and after treatment. Results: Significant differences were found in sperm morphology, protamine deficiency, and apoptosis between the two groups and before and after vitamin C administration. A significant change was found in mRNA levels of PRM1, PRM2, and the PRM1/PRM2 ratio after treatment. Conclusion: Daily oral administration of vitamin C may improve human sperm parameters and DNA integrity by increasing protamine gene expression levels in the male partners of couples with RPL. The beneficial effects of vitamin C supplementation as an antioxidant for the male partners of couples with RPL could lead to improved pregnancy outcomes in these cases.

• Clinical and Experimental Reproductive Medicine
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• v.51 no.1
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• pp.75-84
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• 2024

Objective: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. Methods: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). Results: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. Conclusion: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

• 대한생식의학회:학술대회논문집
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• 2002.11a
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• pp.15-21
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• 2002

In order to keep the normal pregnancy, a number of gene products are required at the feto-matemal interface. We have isolated approximately 30 genes, involved in keeping the normal pregnancy, via subtractive hybridization and RT-PCR analyses of cDNAs from the chorionic villi of normal and RPL patients. Characterizing their functions will help us to understand the process of establishing and maintaining pregnancy. In addition, more detailed studies of their expression in normal and RPL patients are required to evaluate their clinical relevance. Further identification of genes aberrantly expressed in RPL patients will help the prognosis of the pregnancy, identifying pregnancies with a high risk of miscarriage and enabling management of those pregnancies.

• Journal of the Korean Institute of Oriental Medical Informatics
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• v.11 no.1
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• pp.52-57
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• 2005

Objectives : Recurrent pregnancy loss occurs in approximately 0.5-3% of women. There are many studies concerning immunological factor recently. Therefore, aim of this study is to examine the latest trend of researches concerning recurrent pregnancy loss, and controlled experiment on animals about antiphospholipid antibody. Method : We referred Pubmed site by using searching word of 'recurrent pregnancy loss' (Limits : 2000.1-2004.3, animal) Results and conclusions : 1. We searched 29 papers. Immunological factor : 18 ( about antiphospholipid antibody : 10 ), Chromosomal abnormality : 6, The others : 5 2. In five papers about controlled experiment on animals, (1) Materials : 8-12 weeks old mice / 11.5-day old-rat embryos / New Zealand rabbit (2) Inductions : inject intraperitoneally with human IgG containing antiphospholipid antibodies / culture in a solution of 1 ml medium which contained IgG purified from sera of women / inject intradermally with cardiolipin (3) Treatments : inject intraperitoneally with complement component before / culture in a solution of 1 ml medium which contained IgG purified from sera of women with SLE and RPL or from healthy women / inject intradermally with TFX, 0.9% NaCl (4) Measurements : weight fetuses and placentas, calculate frequency of fetal resorption / after culture, examine the embryos / examine platelet counts, APTT and numbers of live and dead newborns, resorbed fetuses, body mass, newborn viability and survival rates.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.3
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• pp.152-158
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• 2017

Objective: To identify the associations between polymorphisms of the 3'-untranslated region (UTR) of methylenetetrahydrofolate reductase (MTHFR) gene, which codes for an important regulatory enzyme primarily involved in folate metabolism, and idiopathic recurrent pregnancy loss (RPL) in Korean women. Methods: The study population comprised 369 RPL patients and 228 controls. MTHFR 2572C > A, 4869C > G, 5488C > T, and 6685T > C 3'-UTR polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis or by TaqMan allelic discrimination assays. Natural killer cell proportions were determined by flow cytometry. Results: The MTHFR 2572-5488-6685 (A-C-T) haplotype had an adjusted odds ratio of 0.420 (95% confidence interval, 0.178-0.994; p= 0.048) for RPL. Analysis of variance revealed that MTHFR 4869C > G was associated with altered $CD56^+$ natural killer cell percentages (CC, $17.91%{\pm}8.04%$; CG, $12.67%{\pm}4.64%$; p= 0.024) and folate levels (CC, $12.01{\pm}7.18mg/mL$; CG, $22.15{\pm}26.25mg/mL$; p= 0.006). Conclusion: Variants in the 3'-UTR of MTHFR are potential biomarkers for RPL. However, these results should be validated in additional studies of ethnically diverse groups of patients.

• 대한생식의학회:학술대회논문집
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• 2006.06a
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• pp.150.1-150.1
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• 2006