SP and Uterine Immunity: A Timing-Based Perspective on Implantation and Reproductive Success: A narrative review

Authors

  • Ola Hamad Salah Rashid
  • Manar Al-Hoda Zaid Mahmood
  • Al-faqheri, Firas Fadhil Al-Masoody
  • Wasan Hamad Jasim
  • Ghada Bassim Raaf
  • Nik Syamim Firdaus
  • Nik Hazlina Nik Hussain
  • Anani Aila Mat Zin
  • Liza Noordin
  • Sarimah Abdullah
  • Zaleha Abdullah Mahdy
  • Nik Ahmad Zuky Nik Lah
  • Abubakar Ibrahim

Keywords:

Embryo Implantation, Endometrium/immunology, Inflammation, Reproductive Techniques, Assisted, SP, Uterus/immunology

Abstract

Seminal plasma plays a multifaceted role in reproduction, extending beyond sperm transport to the modulation of female reproductive tract immunity. Rich in prostaglandins, cytokines, and extracellular vesicles, SP influences endometrial receptivity, embryo implantation, and the immunological dialogue that sustains early pregnancy. This narrative review synthesizes current evidence on the dual actions of SP, supportive and disruptive, on implantation and pregnancy outcomes, with emphasis on the timing of exposure and its implications for reproductive success. A structured literature search of PubMed, Scopus, SCIENCEDIRECT and Web of Science (1990–2025) identified mechanistic, animal, and human studies exploring SP-mediated immune signaling, endometrial response, and implantation outcomes. SP can promote regulatory immune adaptation, angiogenesis, and trophoblast invasion that favor implantation. However, exposure outside the receptive window or under inflammatory conditions may trigger pathological cytokine activation linked to implantation failure, PE, and other gestational complications. Evidence from human and animal models highlights the importance of temporally

 

controlled SP exposure. In assisted reproduction (ART), where natural SP contact is absent, these mechanisms offer translational insight for improving uterine receptivity. The impact of SP on implantation depends critically on timing and maternal immune context. Understanding this balance may guide novel strategies to enhance natural and assisted conception outcomes while minimizing inflammation-associated complications.

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2026-06-19

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Rashid OHS, Zaid Mahmood MA-H, Al-Masoody A- faqheri, FF, Jasim WH, Raaf GB, Firdaus NS, et al. SP and Uterine Immunity: A Timing-Based Perspective on Implantation and Reproductive Success: A narrative review. J Neonatal Surg [Internet]. 2026 Jun. 19 [cited 2026 Jun. 20];15(1s):148-61. Available from: https://jneonatalsurg.com/index.php/jns/article/view/10391

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Vol. 15 No. 1s (2026): Journal of Neonatal Surgery

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