Fellowship in Reproductive Medicine in India: Immunology in Infertility

Today people say everything and then autoimmune. And then they would say everything and then they would say immunological causes. So let us look at what could be the immunological causes for infertility. So, what do we mean by immunology in implant tissue and pregnancy. So it's a complex paradox.

Why do I say it's a complex paradox? The reason is, okay, we have to understand that when you have a baby that is a different blood group that is sitting inside the mother, obviously, it's an allograft. So it's a complex paradox. Mother should be immunocompetent to fight infections, and mother should also have a tolerance to the fetus, which is a semi allograft. So here you have a DC and an NK cell, and then you have the m cells, mother cells, then the t cells, and then the birth cell.

So all this, no, act onto the immunological platform. So why is it important? One, during pregnancy, maternal fetal cells come close to each other just separated by a membrane. Fetal cells have the potential to trigger an immune response. So successful implantation, placental growth and fetal development needs active participation of both maternal and fetal immune system.

So here, you will see that the maternal interface maternal and fetal interface is over here where the maternal villi placental villi is bathed with the fetal circulation. Then here is the placenta and the maternal decidule leukocytes. That's the myometrium here and the decidule on this side. What is important is what is the maternal fetal interface that we're looking at is, of course, the NK cells, that is the natural killer cells, the uterine natural killer cells, the macrophages, the t cells, and the stromal cells, the interstitial cells, and the endovascular DBT cells and the syncytial trophoblasts. Alright?

So when you look at oocyte maturation, alright, you see a lot of changes that occur. So what do you need for oocyte maturation? What are the antibodies here? That is the premature ovarian failure and, of course, the POA, and these are the POR, that poor ovarian response. So ovarian and, anti ovarian antibodies, autoimmune diseases of other organs, and immune cell infiltration in the ovary.

Here, if you look at in the oocyte maturation, you will see the CSF one, the leukocyte inhibiting factor, and the TNF alpha. But if you look at the fertilization, you see the ASA, the IL, interleukin 11, and interleukin eight. So see how many of the immunological factors are working. Alright? So if you look at the endometrium, though, it is uniform with all the villi over here, but all the villi are not capable of implanting.

So what do you have here? One is the LIF MCP, then the IP 10, interleukin one beta, and TNF alpha. So then the T cells, that is from the macrophages, and the NK cells. Then all these things have one common property as of invading the endometrial lining. Look at the implantation systemic factors here.

That is the PbNk count, then the PH one to PH two ratio, then the APA, other autoantibodies, and the HLA alleles, thrombophilia conditions. So for this one for this one to implant, it has to enter in at a place where it is wanted and where nutrition is available and where it is not rejected. And for this trophoblast to enter, that right environment has to be placed. So the trophoblast has entered in and all these things are put to the site. Now what kind of immunity do you have?

One is innate immunity, which is nonspecific immunity, lasts for a few hours, and that is like innate immunity, quick, nonspecific, recognition of pathogens by sensors and activation of cells by inflammation and removal of infectious agents. So this is more humoral that you can see. The other thing is, of course, the adaptive immunity, which is very specific immunity, which lasts for a few days. So what would be that? That would be an adaptive immunity, which is long term specific.

One is that you have infection. It simulates from the lymphoid that is the macrophages, the t cell, the lymphoid cell, and the b cell. That is the bursal lymphocytes that comes from the lymphoid, then expansion and training of effector t and b cells, then migration to the infection site, and then it removes the agent which lasts for a longer time. So if you were to put in an algorithm here, the immune system will take an innate immunity and a specific immunity. The innate immunity would be like a general immunity, like when you take a flu shot.

Medline Academics is another venture by Padma Shri Prof. Dr. Kamin A. Rao which is dedicated to providing education in the field of Reproductive Medicine. The most demanded course of this institution is the Fellowship in Reproductive Medicine. The most unique feature of this institution is the hybrid mode of training, where in the theory is covered completely online and the students attend the simulations in person in our center in Bangalore. The hybrid mode of learning makes it convenient for all. Medline Academics offers hybrid mode of learning for all practicing clinicians.

Besides, they can also complete their Clinical Attachment in Dr Kamini Rao Hospitals which is one of the best IVF treatment centre in Bangalore. The clinical posting is a part of the curriculum in the Fellowship Program in Reproductive Medicine. With our own set-up of the Hospitals now, students have the convenience to complete the simulation training and the clinical postings together under the mentorship of Dr. Kamini Rao. For over 40 years, Padma Shri Prof. Dr. Kamini A Rao has been training 1000+ doctors and helping numerous couples get the joy of having babies. As the best ART clinic, Dr. Kamini Rao Hospitals have a wide range of services and is based two prominent locations of Bangalore, Kumara park and Jayanagar.