1
|
Benagiano G, Mancuso S, Guo SW, Di Renzo GC. Events Leading to the Establishment of Pregnancy and Placental Formation: The Need to Fine-Tune the Nomenclature on Pregnancy and Gestation. Int J Mol Sci 2023; 24:15420. [PMID: 37895099 PMCID: PMC10607313 DOI: 10.3390/ijms242015420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Today, there is strong and diversified evidence that in humans at least 50% of early embryos do not proceed beyond the pre-implantation period. This evidence comes from clinical investigations, demography, epidemiology, embryology, immunology, and molecular biology. The purpose of this article is to highlight the steps leading to the establishment of pregnancy and placenta formation. These early events document the existence of a clear distinction between embryonic losses during the first two weeks after conception and those occurring during the subsequent months. This review attempts to highlight the nature of the maternal-embryonic dialogue and the major mechanisms active during the pre-implantation period aimed at "selecting" embryos with the ability to proceed to the formation of the placenta and therefore to the completion of pregnancy. This intense molecular cross-talk between the early embryo and the endometrium starts even before the blastocyst reaches the uterine cavity, substantially initiating and conditioning the process of implantation and the formation of the placenta. Today, several factors involved in this dialogue have been identified, although the best-known and overall, the most important, still remains Chorionic Gonadotrophin, indispensable during the first 8 to 10 weeks after fertilization. In addition, there are other substances acting during the first days following fertilization, the Early Pregnancy Factor, believed to be involved in the suppression of the maternal response, thereby allowing the continued viability of the early embryo. The Pre-Implantation Factor, secreted between 2 and 4 days after fertilization. This linear peptide molecule exhibits a self-protective and antitoxic action, is present in maternal blood as early as 7 days after conception, and is absent in the presence of non-viable embryos. The Embryo-Derived Platelet-activating Factor, produced and released by embryos of all mammalian species studied seems to have a role in the ligand-mediated trophic support of the early embryo. The implantation process is also guided by signals from cells in the decidualized endometrium. Various types of cells are involved, among them epithelial, stromal, and trophoblastic, producing a number of cellular molecules, such as cytokines, chemokines, growth factors, and adhesion molecules. Immune cells are also involved, mainly uterine natural killer cells, macrophages, and T cells. In conclusion, events taking place during the first two weeks after fertilization determine whether pregnancy can proceed and therefore whether placenta's formation can proceed. These events represent the scientific basis for a clear distinction between the first two weeks following fertilization and the rest of gestation. For this reason, we propose that a new nomenclature be adopted specifically separating the two periods. In other words, the period from fertilization and birth should be named "gestation", whereas that from the completion of the process of implantation leading to the formation of the placenta, and birth should be named "pregnancy".
Collapse
Affiliation(s)
- Giuseppe Benagiano
- Faculty of Medicine and Surgery, Sapienza University of Rome, 00185 Rome, Italy;
- Geneva Foundation for Medical Education and Research, 1206 Geneva, Switzerland
| | - Salvatore Mancuso
- Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Sun-Wei Guo
- Research Institute, Shanghai Obstetrics & Gynecology Hospital, Fudan University, Shanghai 200011, China;
| | - Gian Carlo Di Renzo
- Center for Perinatal and Reproductive Medicine, University of Perugia, 06156 Perugia, Italy
- Department of Obstetrics, Gynecology and Perinatology, I.M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
- Department of Obstetrics & Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| |
Collapse
|
2
|
Conley AJ, Berger T, Del Razo RA, Cotterman RF, Sahagún E, Goetze LR, Jacob S, Weinstein TAR, Dufek ME, Mendoza SP, Bales KL. The onset of puberty in colony-housed male and female titi monkeys (Plecturocebus cupreus): Possible effects of oxytocin treatment during peri-adolescent development. Horm Behav 2022; 142:105157. [PMID: 35338890 PMCID: PMC9250660 DOI: 10.1016/j.yhbeh.2022.105157] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/24/2022] [Accepted: 03/11/2022] [Indexed: 12/29/2022]
Abstract
Oxytocin has been used to treat neurodevelopmental conditions in adolescent patients but possible effects on reproductive development have not been well investigated. The effects of daily intra-nasal oxytocin treatment (12-18 months of age) on puberty and fertility were studied in colony-housed, male and female titi monkeys (Plecturocebus cupreus). Body weight, urinary conjugated pregnanes and estrogens (defining cyclicity) in females, and androgens and sperm in urine of in males, were measured from 1 to 3 years of age to detect puberty. Serum testosterone was also measured in males at 13, 23 and 33 months of age and hemi-castration at 3 years of age enabled assessment of testicular morphometry and oxytocin receptor expression. An oxytocin treatment*time interaction suggested a minor, transient suppression in weight gain after treatment ended. Note that females weighed 10% less across all ages. Oxytocin-treated females exhibited early, spurious ovulations but neither regular cyclicity (≈30 months) nor pregnancies were affected by treatment. Oxytocin did not affect the pubertal increase in urinary androgen or the first appearance of sperm, which occurred as early as 15 months of age. Treatment did delay the puberty-associated rise in serum testosterone in males. All males were pubertal by 22 months and all females by 32 months of age. Although no major male or female fertility outcome was observed, oxytocin demonstrated some physiological effects through a delay of testosterone secretion in males, induction of precocious ovulation in females, and a suppression of general weight gain for the months following treatment.
Collapse
Affiliation(s)
- A J Conley
- Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, United States of America.
| | - T Berger
- Department of Animal Science, University of California, Davis, CA 95616, United States of America
| | - R Arias Del Razo
- Department of Psychology, University of California, Davis, CA 95616, United States of America; California National Primate Research Center, University of California, Davis, CA 95616, United States of America
| | - R F Cotterman
- Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, United States of America
| | - E Sahagún
- Department of Psychology, University of California, Davis, CA 95616, United States of America
| | - L R Goetze
- California National Primate Research Center, University of California, Davis, CA 95616, United States of America
| | - S Jacob
- Department of Psychology, University of California, Davis, CA 95616, United States of America
| | - T A R Weinstein
- Department of Psychology, University of California, Davis, CA 95616, United States of America
| | - M E Dufek
- California National Primate Research Center, University of California, Davis, CA 95616, United States of America
| | - S P Mendoza
- Department of Psychology, University of California, Davis, CA 95616, United States of America; California National Primate Research Center, University of California, Davis, CA 95616, United States of America
| | - K L Bales
- Department of Psychology, University of California, Davis, CA 95616, United States of America; California National Primate Research Center, University of California, Davis, CA 95616, United States of America; Department of Neurobiology, Physiology, and Behavior, University of California, Davis, CA 95616, United States of America.
| |
Collapse
|
3
|
Ţarcă E, Roșu ST, Cojocaru E, Trandafir L, Luca AC, Rusu D, Ţarcă V. Socio-Epidemiological Factors with Negative Impact on Infant Morbidity, Mortality Rates, and the Occurrence of Birth Defects. Healthcare (Basel) 2021; 9:healthcare9040384. [PMID: 33915730 PMCID: PMC8065913 DOI: 10.3390/healthcare9040384] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/16/2022] Open
Abstract
In the last 30-40 years, developed countries in particular, but also developing ones, have seen an increase in life expectancy and a decrease in infant mortality and morbidity rates. These factors are due to an increase in living standards, a decrease in differences between social classes, the increased accessibility of education to women, and the implementation of some public health measures. When certain basic social and medical measures are implemented on a large scale, their benefits are first reflected in lower infant mortality rates, and only in the second stage are such benefits reflected in decreasing neonatal mortality rates and a smaller number of stillbirths. In this study, we review the literature on these factors. We extrapolate and compare this literature with data recorded in our country in the hopes of finding the reasons why Romania ranks first in the European Union in terms of infant mortality rates. We found that lowering the infant morbidity, mortality, and congenital malformation rates is an absolute priority in Romania, which requires the involvement of decision makers in taking effective measures regarding food supplementation or enhancement using folic acid, adequate counselling of couples, monitoring of all pregnancies, setting antenatal diagnosis, implementing optimal delivery management and therapeutic approaches to problematic pregnancies in other hospitals and by involving the population in health education, avoiding occupational or in-home exposure to toxic factors, avoiding drug use, and implementing disease and infection prevention measures for pregnant women.
Collapse
Affiliation(s)
- Elena Ţarcă
- Department of Surgery II-Pediatric Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
- Correspondence: (E.Ţ.); (E.C.)
| | - Solange Tamara Roșu
- Department of Nursing, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania;
| | - Elena Cojocaru
- Department of Morphofunctional Sciences I—Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
- Correspondence: (E.Ţ.); (E.C.)
| | - Laura Trandafir
- Department of Mother and Child Medicine–Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (L.T.); (A.C.L.)
| | - Alina Costina Luca
- Department of Mother and Child Medicine–Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (L.T.); (A.C.L.)
| | - Daniela Rusu
- Department of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania;
| | - Viorel Ţarcă
- County Statistics Department, 700115 Iaşi, Romania;
| |
Collapse
|