Role of inflammatory mediators in patients with recurrent pregnancy loss

Objective: To examine interleukin-12 (IL-12), IL-18, IFN-gamma, intracellular adhesion molecule-1 (ICAM-1), leukemia inhibitory factor (LIF), and migration inhibitory factor (MIF) levels in precisely-timed blood and endometrial tissue samples from women with idiopathic recurrent pregnancy loss (RPL). Design: Case-control study. Setting: University hospital. Patient(s): Twenty-one women with RPL and 20 women with proven fertility (controls). Intervention(s): Primary endometrial cells and blood samples during the midsecretory phase (days 19-23). Main Outcome Measure(s): Detection of IL-12, IL-18, IFN-gamma, ICAM-1, LIF, and MIF via enzyme-linked immunosorbent assay in both blood and endometrial tissue samples. Result(s): The blood and tissue levels of IL-12, IL-18, and IFN-gamma were statistically significantly higher, and the blood and tissue levels of LIF and MIF were statistically significantly lower in patients with RPL. Only the level of tissue ICAM-1 was higher in patients with RPL. There was a strong correlation between blood and tissue level measurements of IL-12, IL-18, LIF, and MIF. Conclusion(s): Our findings support the hypothesis that inflammatory processes may contribute to pregnancy loss, possibly through their role in implantation. We found that blood and tissue levels of IL-18, LIF, and MIF, and tissue levels of IL-12, IFN-gamma, and ICAM-1 have statistically significant prognostic relevance. (C) 2015 by American Society for Reproductive Medicine.