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Intrauterine insemination of cultured peripheral blood mononuclear cells prior to embryo transfer improves clinical outcome for patients with repeated implantation failures

Published online by Cambridge University Press:  23 January 2015

Aicha Madkour ,
Nouzha Bouamoud ,
Noureddine Louanjli ,
Ismail Kaarouch ,
Henri Copin ,
Moncef Benkhalifa  and
Omar Sefrioui
Aicha Madkour
Affiliation:
Anfa Fertility Center, Privante Clinic of Human Reproduction and Endoscopic Surgery, Casablanca, Morocco. Biochemistry and Immunology Laboratory, Mohammed V University, Faculty of Sciences, BP 1014, Avenue Ibn Batouta Agdal, Rabat, Morocco. Labomac, Laboratory of Medical Analysis, Casablanca, Morocco.
Nouzha Bouamoud
Affiliation:
Biochemistry and Immunology Laboratory, Mohammed V University, Faculty of Sciences, BP 1014, Avenue Ibn Batouta Agdal, Rabat, Morocco.
Noureddine Louanjli
Affiliation:
Anfa Fertility Center, Privante Clinic of Human Reproduction and Endoscopic Surgery, Casablanca, Morocco. Labomac, Laboratory of Medical Analysis, Casablanca, Morocco.
Ismail Kaarouch
Affiliation:
Anfa Fertility Center, Privante Clinic of Human Reproduction and Endoscopic Surgery, Casablanca, Morocco. Biochemistry and Immunology Laboratory, Mohammed V University, Faculty of Sciences, BP 1014, Avenue Ibn Batouta Agdal, Rabat, Morocco. Labomac, Laboratory of Medical Analysis, Casablanca, Morocco.
Henri Copin
Affiliation:
Reproductive Biology and Medical Cytogenetics Laboratory, Regional University Hospital & School of Medicine, Picardie University Jules Verne, Amiens, France.
Moncef Benkhalifa*
Affiliation:
Reproductive Biology and Medical Cytogenetics Laboratory, Regional University Hospital & School of Medicine, Picardie University Jules Verne. Amiens. France.
Omar Sefrioui
Affiliation:
Anfa Fertility Center, Privante Clinic of Human Reproduction and Endoscopic Surgery, Casablanca, Morocco.
*
All correspondence to: M Benkhalifa. Reproductive Biology and Medical Cytogenetics Laboratory, Regional University Hospital & School of Medicine, Picardie University Jules Verne. Amiens. France. Tel: +33 677867390. Fax: +33 130571934. e-mail: benkhalifamoncef78@gmail.com
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Summary

Implantation failure is a major limiting factor in assisted reproduction improvement. Dysfunction of embryo–maternal immuno-tolerance pathways may be responsible for repeated implantation failures. This fact is supported by immunotropic theory stipulating that maternal immune cells, essentially uterine CD56+ natural killer cells, are determinants of implantation success. In order to test this hypothesis, we applied endometrium immuno-modulation prior to fresh embryo transfer for patients with repeated implantation failures. Peripheral blood mononuclear cells were isolated from repeated implantation failure patients undergoing assisted reproductive technology cycles. On the day of ovulation induction, cells were isolated and then cultured for 3 days and transferred into the endometrium cavity prior to fresh embryo transfer. This immunotherapy was performed on 27 patients with repeated implantation failures and compared with another 27 patients who served as controls. Implantation and clinical pregnancy were increased significantly in the peripheral blood mononuclear cell test versus control (21.54, 44.44 vs. 8.62, 14.81%). This finding suggests a clear role for endometrium immuno-modulation and the inflammation process in implantation success. Our study showed the feasibility of intrauterine administration of autologous peripheral blood mononuclear cells as an effective therapy to improve clinical outcomes for patients with repeated implantation failures and who are undergoing in vitro fertilization cycles.

Keywords

Endometrium immuno-modulationIn vitro fertilization and fresh embryo transferPeripheral blood mononuclear cellsRepeated implantation failure
Type
Research Article
Information
Zygote , Volume 24 , Issue 1 , February 2016 , pp. 58 - 69
Copyright
Copyright © Cambridge University Press 2015 

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