Disorders of Early development

Question 1

loss before pregnancy detection?

Answer 1

40%

30-74% before implantation

Question 2

monthly probability of conception?

Answer 2

15-25%

Question 3

% of clinically recognized pregnancy loss?

Answer 3

10%

Question 4

when are you most likely to miscarry?

Answer 4

first trimester

80%

Question 5

major driver of early pregnancy loss?

Answer 5

aneuploidy
which is chromosomal error
like trisomy, monosomy,tetrasomy

Question 6

what increases risk of trisomoic pregnancy?

Answer 6

AGE
50% of lost early pregnancies display chromosomal errors

Exponential increase in risk of trisomic pregnancy with increasing maternal age

Question 7

why does maternal age increase risk of miscarriage?

Answer 7

loss of proteins {COHESIN}
so homologues not being held together
= aneuploidy

Question 8

why does maternal age impact miscarriage?

Answer 8

loss of cohesion between homologous chromosomes in oocyte with increasing age

Question 9

Recurrent miscarriage

defn

Answer 9

loss of three or more consecutive pregnancies, affects 1% of couples trying to conceive

Question 10

Recurrent implantation failure

defn

Answer 10

refers to cases in which women have had three failed in vitro fertilization (IVF) attempts with good quality embryos

Question 11

diagnostic approaches for pregnancy loss?

Answer 11

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?

Question 12

signalling pathways implicated in RIF/ RM?

if implantation is problem

Answer 12

Leukemia inhibtory factory deficiency - LIF : cytokine

{if problem is implantation]

Question 13

why is LIF important?

Answer 13

LIF promotes decidulaisation of human endometrial stromal cells in culture

progesterone is the pimary driver but LIF is also important

Question 14

whta other signalling mechanism could impact?

Answer 14

embryo to maternal signalling

Question 15

what is endometrial scratching?

Answer 15

Use of pipette or hysteroscope to damage endometrial mucosa before embryo transfer in IVF

Question 16

what is it thought to do?

Answer 16

stimulate immune cell infiltration and wound healing cytokine production

creating a growth factor environment which is more conducive to implantation

Question 17

how does smoking impact miscarriage
where is the impact?
what in cigarettes?

Answer 17

fallopian tube - expression of PROKR1

by continine [component of cig smoke]

reduces transit of embryo through fallopian tube
= ectopic pregnancy

Question 18

what is the relevance of PROKR1 ?
where is it found?
whta does it do?

Answer 18

regulatory of smooth muscle contractility in fallopian tubes

continine found in cig smoke inhibits

Question 19

3 methods smoking impacts fallopian tube?

Answer 19

prokr1 expression downregulated - affects contractility

increases pro-apoptotic proteins in FT

smoke inhibtis ciliary function- affects transit of embryo out of tube

Question 20

cannabinoid receptors are found where?

Answer 20

fallopian tube

CB1 and CB2

Question 21

effects of cannabis on FT

Answer 21

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

Question 22

CB1 is ____ in ectopic pregnancy

Answer 22

reduced

dysregulation impact of cannabis?