C Pregnancy

Question 1

Define allogeneic

- give an example of something: semi-allogeneic

Answer 1

Tissues or cells which are genetically dissimilar and hence immunologically incompatible, although from individuals of the same species.
- fetus

Question 2

Describe Maternal-Fetal interface

Answer 2

Decidua - mucosal membrane of pregnant uterus

1. Must promote tolerance to the fetus (as fetal-expressed antigens are foreign
2. Must also maintain defence against a diverse array of possible pathogens

Question 3

Name the stages of pregnancy

Answer 3

Intercourse 
Implantation 
Gestation: (1st to 3rd trimester)
Parturition (labour)  
post partum repair

Question 4

What hormones rise in pregnancy

Answer 4

Estrogen & progesterone

& HCG

Question 5

Leukocytes make up ~6-20% of which cells

• what are they organised by
• What is found in basal layer of the endometrium

Answer 5

Fallopian tubes, endometrium, cervix & vaginal mucosa.

• Progesterone & estrogen
• organised lymphoid aggregates of B cell core surrounded bt Tc (mainly CD8)

Question 6

Describe stages from ovulation to implantation

Answer 6

Oocyte released from ovary 
Day 0: Zygote - egg is fertilised 
Day 1: First cleavage 
Day 2: 2-cell stage 
Day 3-4: 8 cell uncompacted morula 
Day 4: 8 cell compacted morula 
Day 5: Early blastocyst 
Day 6-7: Last stage blastocyst (hatching) 
Day 8-9: Implantation of the blastocyst

Question 7

Define Decidua

Answer 7

Uterine lining (endometrium) during pregnancy

Question 8

What is the immediate response to insemination

- Role of the inflammatory response

Answer 8

Rapid & dramatic influx of inflammatory cells into the site of semen deposition.
- Process seminal material + recovery of tissue homeostasis after mating

Question 9

Semen contains

• what does this cause production of
• recruitment of which cells & their role

Answer 9

TGF-B, IL-8, IFNy, Prostaglandin E –> contacts the uterine epithelium = production pro-inflam cytokines: IL-6, GM-CSF, LIF + chemokines: CCL2, CXCL1, CCL5
Chemokines recruit cells ((to endometrial stroma?))
1. DC: processing/ presentation of seminal Ag to active maternal immune tolerance
2. Macrophages: secrete growth factors, MMP, enzymes for tissue remodelling
3. Clearance of debris & pathogens introduced at mating + evidence for sperm selection.

Question 10

What does seminal plasma do to the uterine immune environment

Answer 10

Modulates it to prevent fetal rejection
Antigens w/in seminal plasma primes the maternal immune system.
The initial presentation of paternal alloantigens to maternal Tc after ejaculation is suggested to be crucial for tolerance of the conceptus, which displays the same paternal antigens during implantation a few days later.

Question 11

How can live birth rate be improved in couples undergoing IVF treatment

Answer 11

Significantly improved when women are exposed to semen at the time of embryo transfer.
- as seminal fluid has a role in prompting successful pregnancy

Question 12

What is the function of the endometrium

• undergoes cycles of what
• what do these cycles enable

Answer 12

Allow blastocyst implantation & support pregnancy

• repeated cycles involving sequential proliferation, differentiation, breakdown and repair
• tissue remodelling ensures the endometrium is in a receptive state during the implantation window

Question 13

Who are at increased risk of preeclampsia

- can this be partner specific

Answer 13

people with limited sexual experience or use of barrier methods for contraception being linked with
woman pregnant by donor occytes/ sperm
increased risk.
- yes