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Endometrium immunomodulation by intrauterine insemination administration of treated peripheral blood mononuclear cell prior frozen/thawed embryos in patients with repeated implantation failure

Published online by Cambridge University Press:  19 July 2019

Fattaneh Farifteh Nobijari
Affiliation:
Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1985717444, Iran Genetics and In Vitro Assisted Reproductive (GIVAR) Center, Erfan Hospital, Tehran 1998884349, Iran
Seyedeh Soheila Arefi
Affiliation:
Genetics and In Vitro Assisted Reproductive (GIVAR) Center, Erfan Hospital, Tehran 1998884349, Iran Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran 1941913114, Iran
Ashraf Moini
Affiliation:
Genetics and In Vitro Assisted Reproductive (GIVAR) Center, Erfan Hospital, Tehran 1998884349, Iran Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran 1665659911, Iran
Robabeh Taheripanah
Affiliation:
Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, 1985711151, Iran
Elham Fazeli
Affiliation:
Department of Anatomy and Reproductive Biology, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
Hamideh Kharazi
Affiliation:
Genetics and In Vitro Assisted Reproductive (GIVAR) Center, Erfan Hospital, Tehran 1998884349, Iran
Seyedeh Zeinab Hosseini
Affiliation:
Genetics and In Vitro Assisted Reproductive (GIVAR) Center, Erfan Hospital, Tehran 1998884349, Iran
Ahmad Hosseini
Affiliation:
Genetics and In Vitro Assisted Reproductive (GIVAR) Center, Erfan Hospital, Tehran 1998884349, Iran
Mojtaba Rezazadeh Valojerdi
Affiliation:
Genetics and In Vitro Assisted Reproductive (GIVAR) Center, Erfan Hospital, Tehran 1998884349, Iran Department of Anatomy, School of Medical Sciences, Tarbiat Modares University, Tehran, 14115111, Iran
Henri Copin
Affiliation:
IVF and Reproductive Genetics, University Hospital and School of Medicine, Picardie University Jules Verne, 80054 Amiens Sud, France
Moncef Benkhalifa*
Affiliation:
IVF and Reproductive Genetics, University Hospital and School of Medicine, Picardie University Jules Verne, 80054 Amiens Sud, France PERITOX Laboratory, CURS, Université de Picardie Jules Vernes Amiens, France
*
*Address for correspondence: Moncef Benkhalifa. University Hospital and School of Medicine, Jules Verne University of Picardie, Amiens 80054, France. Tel: +33 677 867-390. Fax:+33 130 571 934; E-mail: benkhalifamoncef78@gmail.com

Summary

In assisted reproductive technology (ART) programmes, approximately 10% of infertile patients have at least two or three repeated implantation failures (RIFs) after an in vitro fertilization (IVF) protocol. Successful implantation mainly depends on local immune tolerance mechanisms involving a spectrum of cytokines, interleukins and growth factors. The latter have played pivotal roles in the recruitment of immune cells (and notably T-lymphocyte cells). In total, 250 couples participating in frozen–thawed embryo transfer programme were incorporated in a randomized clinical trial (peripheral blood mononuclear cells (PBMC) subgroup: n=122; control subgroup: n=128). In the PBMC group, a blood sample was collected 5 days before the scheduled frozen–thawed embryo transfer; PBMCs were isolated using Ficoll separation and then cultured for 72 h. Two days prior to embryo transfer, 0.4 ml of cultured PBMCs were transferred into the patient’s uterus. Although the clinical pregnancy rate was higher in the PBMC group (34.4%) than in the control group (23.4%), this difference was not statistically significant (P=0.05 in a chi-squared test). Nevertheless, when we limited the analysis to patients with ≥3 RIFs (n=138), there was a significant difference in the clinical pregnancy rate between the PBMC group (38.6%) and the control group (19.7%; P=0.01). Our results imply that PBMC transfer can be part of effective fertility treatment for patients with RIF.

Type
Research Article
Copyright
© Cambridge University Press 2019 

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