Disorders of Early Development Flashcards
How common is miscarriage after pregnancy is confirmed?
10%
How common is miscarriage before pregnancy is confirmed?
40%
What is major contributor to pregnancy loss before 12 weeks’ gestation?
Chromosomal abnormalities
What happens to risk of miscarriage as people get old? Why?
Greatly increases as chromosomal abnormalities increase
Define recurrent miscarriage
3 or more consecutive pregnancy losses
Define recurrent implantation failure
Failure to achieve a clinical pregnancy after transfer of at least three good-quality embryos in IVF
What is the key difference between recurrent miscarriage and recurrent implantation failure?
Failure to implant or sustain pregnancy by natural conception vs failure of transferred embryo to implant/sustain pregnancy
What are some common causes of recurrent miscarriage and recurrent implantation failure?
Uterine anatomical defects or presence of fibroids/polyps that might disrupt implantation
Autoimmune antibodies e.g. anti-nuclear, anti-phospholipid
Also test for paternal DNA sperm integrity/fragmentation
What signalling pathway is associated with miscarriage?
LIF (leukemia inhibitory factor) pathway
What does LIF deficiency do?
Causes failure in implantation
What LIF promote?
Decidualization of human endometrial stromal cells
Whats endometrial scratching?
A technique used to improve the ability of an embryo to implant in the uterus after in-vitro fertilization
How is endometrial scratching carried out?
It involves superficially wounding the endometrial mucosa of the womb using a pipette or hysteroscope
What is endometrial scratching though to stimulate?
Immune cell infiltration and wound healing cytokine production
What are some adaptations the fallopian tube has to promote transition into the uterus?
Smooth muscle contracts to move the embryo along the tube
Epithelium is coated in cilia (microvilli) to promote fluid movement