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And Then the Day Changes… Miscarriages Explained?

After gritting my teeth this morning as I read Rep. Gingrey’s comments on what infertility has in common with “legitimate rape,” I then opened the Stir a few minutes ago to see that a study has found a possible explanation for why miscarriages occur.  According to that post,

In a study, laboratory tests showed that women who had lost three or more babies had high levels of a molecule known as IL-33 in their womb cells. These molecules control whether or not the uterus accepts an embryo.

The study was published in a journal called PLOS ONE, and it seems to go hand-in-hand with an earlier study that came out this past summer in Journal of Reproductive Immunology.  And while I know a bunch of you roll your eyes at the fact that I read the Daily Mail from time to time (but strangely enough don’t roll your eyes at the fact that People magazine is my Bible?), I thought they had a very good, simple explanation of what the study found.

Your thoughts?

 

8 comments

1 Trisha { 01.12.13 at 7:25 pm }

I’m hesitant but mostly because at this point I’ve accepted that I will most likely never have an answer. However, I’d be interested to see where this goes and if it gets picked up for further research.

2 a { 01.12.13 at 7:46 pm }

Interesting. I think that there must be something. So what this is saying is that the molecule allows implantation of substandard fertilized eggs? Which then leads to miscarriage? Or it makes for a hostile environment? Substandard fertilized eggs would still be a problem, then, but the hostile environment factor for those embryos with no genetic defects could be treated. I hope further study is in the works…

3 Polly Gamwich { 01.12.13 at 7:50 pm }

I’ve wondered if I miscarry so much (x5) because my uterus is less discerning than others’. (I didn’t read the article, but will.)

4 Cristy { 01.12.13 at 9:55 pm }

I need to read this carefully, but the thing that immediately sticks out is that the researchers worked on cell lines but did not look for IL-33 in women with a history of recurrent pregnancy loss. Hence I’m suspicious. Reminds me of the “Super Fertile” article that was also in PLoS One over the summer that concluded the showed terrible data and tried to argue that the reason RPLers were miscarrying was because their uteruses where more readily accepting poor quality embryos. That one was complete BS, so I wonder . . . .

5 Ladyblogalot { 01.12.13 at 11:46 pm }

It makes me happy that so many people are researching, testing, experimenting, discovering… each time a study like this is done, even if it doesn’t bring with it a magic cure, it furthers our knowledge and understanding and generates new ideas and discussions on just what goes on in there. And I wouldn’t have read this one if you hadn’t pointed it out so thank you very much, lady! Your work here is done… you may go back to People now…

6 A Passage to Baby { 01.13.13 at 12:20 am }

Will have to try and read again tomorrow. The Gingrey thing has seriously made me ill.
Sometimes I love my state, but sometimes I hate it.

7 Sara { 01.13.13 at 1:24 am }

I think this is really exciting, and together with a few other recent articles (including those that you and Cristy mentioned) add to a growing understanding of the factors that seem to be driving one cause of recurrent miscarriage. Does this mean that all cases of RM can be explained? Alas, no. RM is clearly a multifactorial problem. Also, understanding the problem doesn’t mean that a solution is on the horizon. Indeed, in this case, it appears that there is a coherent explanation now for the molecular factors that create the conditions for RM, but not for WHY the IL-33/ST2L/sST2 axis is disordered in some women but not others. Still, knowledge is power, and I wouldn’t be surprised if in time, this does lead to interventions that are helpful in at least some cases of RPL.

On a perhaps unrelated note–I feel a bit frustrated when I see comments that make statements about published research articles such as “that one was complete BS.” Dismissing the fruits of someone else’s labor as BS without specifics isn’t helpful or informative. I have seen ALI blogs criticizing PLoS One as a publication and the paper that the poster refers to specifically and I think that a lot of the comments were very misguided, and may have been driven by a misunderstanding of the journal and basic data analysis. It is true that PLoS One does not make the perceived “importance” of a paper a criterion for acceptance, but they do peer review for quality to make sure that the research was done correctly and that the conclusions are reasonable given the results. Most of my colleagues send their best work to PLoS One, because as a popular open access platform, it is a great venue for showcasing your work to a broader audience than the normal specialist journals. And as for criticisms of the quality of the data in the “super-fertile” article, an experiment that includes a lot of error (i.e., data with poor quality control, as opposed to biased data) should lead to non-significant results (i.e., a finding of no difference between women with RPL and without RPL) , not false results. So, unless the critics are accusing the authors of deliberate falsification, all of the criticisms that I’ve seen shouldn’t undermine the actual conclusions of the article. The fact that the popular press didn’t really understand the article and portrayed it in a misleading and offensive way isn’t the scientists’ fault. The authors never said that women with RPL are “super fertile”. Rather the authors of the paper described the endometria of women with RPL as “super-receptive,” which this paper appears to confirm.

To a, above, the paper is saying mainly that the failure of the normal signalling system that involves IL-33 and the ST2 receptor may allow implantation of embryos (substandard or not) in an endometrium that is not properly prepared for ongoing pregnancy, and the system malfunction creates ongoing inflammation in the endometrium after implantation, which can also lead to pregnancy loss.

Finally, in response to Cristy, the authors of the recent PLoS One paper DID look for IL-33 in women with a history of recurrent pregnancy loss. See the section of the results entitled: “The IL-33/ST2L/sST2 Axis is Deregulated in Decidualizing HESCs from RPL”. In standard English, that translates to something like “the signaling system that involves IL-33,ST2L, and sST2 is out of whack in endometrial cells of patients with repeated pregnancy loss during the section of the luteal phase when implantation occurs”. Yes, they did this on cells cultured in the lab (after cultures were taken from actual women), since that is the only way to control what’s going on, but the cells came from women with RPL and were compared with a control group of women without RPL.

8 Valery Valentina { 01.14.13 at 2:26 am }

@Sara: Thank you for translating and explaining!

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