Disorders of Early development Flashcards
loss before pregnancy detection?
40%
30-74% before implantation
monthly probability of conception?
15-25%
% of clinically recognized pregnancy loss?
10%
when are you most likely to miscarry?
first trimester
80%
major driver of early pregnancy loss?
aneuploidy
which is chromosomal error
like trisomy, monosomy,tetrasomy
what increases risk of trisomoic pregnancy?
AGE
50% of lost early pregnancies display chromosomal errors
Exponential increase in risk of trisomic pregnancy with increasing maternal age
why does maternal age increase risk of miscarriage?
loss of proteins {COHESIN}
so homologues not being held together
= aneuploidy
why does maternal age impact miscarriage?
loss of cohesion between homologous chromosomes in oocyte with increasing age
Recurrent miscarriage
defn
loss of three or more consecutive pregnancies, affects 1% of couples trying to conceive
Recurrent implantation failure
defn
refers to cases in which women have had three failed in vitro fertilization (IVF) attempts with good quality embryos
diagnostic approaches for pregnancy loss?
implantation affected by fibroids or polyps? is problem uterine
Determine presence of auto-immune antibodies (anti-nuclear, anti-phospholipid antibodies)
Test sperm; intact? alive? fragmentated?
signalling pathways implicated in RIF/ RM?
if implantation is problem
Leukemia inhibtory factory deficiency - LIF : cytokine
{if problem is implantation]
why is LIF important?
LIF promotes decidulaisation of human endometrial stromal cells in culture
progesterone is the pimary driver but LIF is also important
whta other signalling mechanism could impact?
embryo to maternal signalling
what is endometrial scratching?
Use of pipette or hysteroscope to damage endometrial mucosa before embryo transfer in IVF
what is it thought to do?
stimulate immune cell infiltration and wound healing cytokine production
creating a growth factor environment which is more conducive to implantation
how does smoking impact miscarriage
where is the impact?
what in cigarettes?
fallopian tube - expression of PROKR1
by continine [component of cig smoke]
reduces transit of embryo through fallopian tube
= ectopic pregnancy
what is the relevance of PROKR1 ?
where is it found?
whta does it do?
regulatory of smooth muscle contractility in fallopian tubes
continine found in cig smoke inhibits
3 methods smoking impacts fallopian tube?
prokr1 expression downregulated - affects contractility
increases pro-apoptotic proteins in FT
smoke inhibtis ciliary function- affects transit of embryo out of tube
cannabinoid receptors are found where?
fallopian tube
CB1 and CB2
effects of cannabis on FT
THC in cannabis may act directly on the fallopian tube to peturb transit, or alter the balance of endocannabinoids (the ‘endocannabinoid tone’) in the tube leading to a disrupted embryo environmen
CB1 is ____ in ectopic pregnancy
reduced
dysregulation impact of cannabis?
