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Mol. Hum. Reprod. Advance Access published online on April 3, 2009
Molecular Human Reproduction, doi:10.1093/molehr/gap027
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Do circulating blood cells contribute to maternal tissue remodeling and embryo-maternal cross-talk around the implantation period?{dagger}

Hiroshi Fujiwara

Department of Gynecology and Obstetrics, Faculty of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan.

Address correspondence to: Hiroshi Fujiwara, M.D., Department of Gynecology and Obstetrics, Faculty of Medicine, Kyoto University, Sakyo-ku, Kyoto, 606-8397, Japan. Tel: 81-75-751-3269 Fax: 81-75-761-3967 E-mail: fuji{at}kuhp.kyoto-u.ac.jp

In early pregnancy, human chorionic gonadotropin (HCG) stimulates the corpus luteum of pregnancy to produce progesterone that in turn maintains human embryo implantation in the uterus. In addition to this embryo-maternal cross-talk via the endocrine systems through blood circulation, accumulating evidence suggests that circulating blood cells also play an important role in embryo implantation. Peripheral blood mononuclear cells (PBMC) derived from pregnant women increased the progesterone production by luteal cells and promoted the invasion of embryos in vitro. Recombinant-HCG increased chemokine production by PBMC through lectin-glycan interaction and enhanced the effects of PBMC on embryo invasion. Later, it was shown that not only PBMC, but also circulating platelets were possible sources of these chemokines that promote extravillous trophoblast invasion to reconstruct maternal endometrial artery. Circulating platelets were also proposed to induce neovascularization during corpus luteum formation. Furthermore, intrauterine administration of autologous PBMC effectively improved live birth, pregnancy and implantation rates in patients( n=35) with repeated (4 or more) implantation failures during in vitro fertilization therapy. These findings suggest that circulating blood cells positively contribute to maternal tissue remodeling and embryo-maternal cross-talk around the implantation period in cooperation with the endocrine system.

Key Words: corpus luteum/cross-talk/embryo implantation/endometrial differentiation/trophoblast invasion

{dagger} Presented at the International symposium on Reproductive Biology in Beiijing October 2008

Submitted on September 18, 2008; resubmitted on March 20, 2009; accepted on March 26, 2009.


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