As we had planned on returning to reproductive immunology as a main subject for the June issue of the VOICE, our colleague Jeffrey Braverman, MD, who had made reproductive immunology his clinical life’s main subject, at unreasonably young age passed away (see his obituary on page 3). This issue of the VOICE has, therefore, become an unplanned testimonial to Dr. Braverman’s appreciation of the importance of reproductive immunology, as we here describe how much (or should we better say, how little) is known about how the female immune system under normal pregnancy circumstances manages to “accept” and immunologically “tolerate” an implanting “parasite,” the embryo. This parasite then, on top, demonstrates exponential growth over an average 38 weeks of intrauterine life, before, ultimately, being rejected by the maternal immune system by ending tolerance in a process leading to labor. Despite significant progress in understanding of the immune system and how it, actually, in many of its functions cannot at all be separated from the endocrine system, reproductive immunology has remained a controversial area of reproductive medicine, though increasingly difficult to ignore (as most of the infertility field has done for much too long). Boundaries between these two distinct specialties, may just have been drawn up by still limited human knowledge!
In this issue of the CHR VOICE, we cover:
- How maternal immune system learns to tolerate and protect the implanting embryo
- Obituary: Jeffrey Braverman, MD
- When to suspect immunological infertility
- How to test for and diagnose immunological infertility
- Treatments for immunological infertility