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The handle http://hdl.handle.net/1887/66124 holds various files of this Leiden University

dissertation.

Author: Meuleman, T.

Title: Paternal factors in recurrent miscarriage : a role beyond conception

Issue Date: 2018-10-09

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Paternal factors in recurrent miscarriage;

A role beyond conception

Tess Meuleman

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The studies described in this thesis were performed at the Department of Immunohe- matology and Blood Transfusion and the Department of Gynaecology and Obstetrics at the Leiden University Medical Center, the Netherlands.

Cover Wendy Schoneveld | Wenz id Layout Renate Siebes | Proefschrift.nu

Printed by ProefschriftMaken | www.proefschriftmaken.nl ISBN 978-94-930-1986-7

© 2018 Tess Meuleman

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage or retrieval system, without permission in writing from the author.

Financial support for printing this thesis was kindly provided by the department of Gynaecology and Obstetrics Leiden University Medical Center, Nationaal Referentie Centrum voor Histocompatibiliteit, Stichting Oranjekliniek, Stichting NVLE Fonds, Stichting

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Paternal factors in recurrent miscarriage;

A role beyond conception

Proefschrift

ter verkrijging van

de graad van Doctor aan de Universiteit Leiden, op gezag van Rector Magnificus prof.mr. C.J.J.M. Stolker,

volgens besluit van het College voor Promoties te verdedigen op dinsdag 9 oktober 2018

klokke 15.00 uur

door

Tess Meuleman

geboren te Sittard in 1984

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Promotoren Prof. dr. F.H.J. Claas Prof. dr. J.J.M. van Lith

Leden promotiecommissie Prof. dr. F. Koning Prof. dr. S. Robertson

Robinson Research Institute, Adelaide, Australia

Prof. dr. I. Joosten

RadboudUMC, Nijmegen

Dr. S. Heidt

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Chapter 1 General introduction 7 Chapter 2 HLA associations and HLA sharing in recurrent miscarriage: a

systematic review and meta-analysis

29

Chapter 3 Lower frequency of the HLA-G UTR-4 haplotype in women with unexplained recurrent miscarriage

57

Chapter 4 Paternal HLA-C is a risk factor in unexplained recurrent miscarriage

75

Chapter 5 Beneficial or harmful effect of anti-paternal human leukocyte antibodies on pregnancy outcome? A systematic review and meta-analysis

95

Chapter 6 HLA-C antibodies in women with recurrent miscarriage suggests that antibody mediated rejection is one of the mechanisms leading to recurrent miscarriage

113

Chapter 7 Increased complement C4d deposition at the maternal-fetal interface in unexplained recurrent miscarriage

129

Chapter 8 The immunomodulating effect of seminal plasma on T cells 145 Chapter 9 Oral sex is associated with reduced incidence of recurrent

miscarriage

165

Chapter 10 Summary and general discussion 185

Chapter 11 Nederlandse samenvatting 203

Chapter 12 List of abbreviations 212

Authors’ affiliations 214

List of publications 216

Curriculum vitae 218

Dankwoord 219

Table of contents

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