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Hormones Immune

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Controversies and Current Research The immune system in menopause and infertility Northside Hospital WomenFirst February 26, 2002 Mark Perloe, M.D., mpmd@ivf.com www.ivf.com
Controversies and Current Research The immune system in menopause and infertility ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Immune Cells ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Immune Cells
Human Leukocyte Antigens HLA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cytokines ,[object Object],[object Object],[object Object],[object Object]
Cytokine Response
Complement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Immune System Sexual Dimorphism ,[object Object],[object Object],[object Object]
Autoimmune Disorders 20/1 792 Hashimoto’s Thyroiditis 3/1 860 Rheumatoid Arthritis Not known 151 Pernicious Anemia 1/1 192 IDDM 8/1 1152 Grave’s Disease Female-Male Ratio Prevalence Rate/100,000 Disease
Systemic Lupus Erythematosus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Role of Sex Steroid Hormone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Estrogen ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Progesterone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Androgens ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pregnancy ,[object Object],[object Object],[object Object]
Is the pregnant uterus an immune-privileged site? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pregnancy Loss Prevalence ,[object Object],[object Object],[object Object]
Spectrum of Pregnancy Loss ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recurrent pregnancy loss autoimmunity and pregnancy loss ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recurrent pregnancy loss Alloimmunity: pregnancy as an allograft ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antiphospholipid Antibodies & Infertility ,[object Object]
NK-Cells and Infertility
Sperm Antibodies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sperm Antibodies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cumulative Pregnancy Rates OR….. Will I ever conceive ?
ICSI maximizes fertilization
Endometriosis
Endometriosis
Endometriosis
Estrogen & Natural Killer Activity
Anti-Ovarian Antibodies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Internet Resources ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Caveats & Limitations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Study Types ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Evaluating Medical Studies ,[object Object],[object Object],[object Object],[object Object]
Evaluating Medical Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What’s a Meta-analysis? ,[object Object],[object Object]
Meta-Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Decision-making ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Hormones Immune

Notas del editor

  1. Assignment of individuals is randomized RCT: Individuals similar at the beginning RCOT: Prospective analytical, susceptible to bias if carry over effects occur Observational: allocation or assignement is not under investigator control; weaker potential evidence; potential for large confounding variables Cohort: prospective, follow-up period to determine effect of exposure and outcome, stronger than case-control but more expensive Case-Control: retrospective, secondary data from chart review, useful for rare conditions, inexpensive, many forms of bias Cross-Sectional: descriptive study of relationship between factors at one point in time Case-Series: series of cases, lack of comparability, source of hypothesis, most common study type Case-Report: anecdotal evidence,