Changes in the T-helper 1 and 2 cell populations during pregnancy in tacrolimus-treated women with repeated implantation failure and recurrent pregnancy loss

Abstract Background: This retrospective cohort study determines whether noninvasive chromosome screening (NICS) for aneuploidy can improve the clinical outcomes of patients with recurrent pregnancy loss (RPL) or repeated implantation failure (RIF) in assisted reproductive technology.Methods: A total of 273 women with a history of RPL or RIF between 2018 and 2021 were included in this study. We collected data of all oocyte retrieval cycles and single blastocyst resuscitation transfer cycles.Results: For the RPL patients, NICS reduced the miscarriages rate per frozen embryo transfer (FET), improved the ongoing pregnancies rate and live birth rate: 17.9% vs 42.6%, adjusted OR 0.39, 95% CI 0.16–0.95; 40.7% vs 25.0%, adjusted OR 2.00, 95% CI 1.04–3.82; 38.9% vs 20.6%, adjusted OR 2.53, 95% CI 1.28–5.02, respectively. For the RIF patients, the pregnancy rates per FET in the NICS group were significantly higher than in the non-NICS group (46.9% vs. 28.7%, adjusted OR 2.82, 95% CI 1.20–6.66).Conclusions: This study demonstrated that selection of euploid embryos through NICS can reduce the miscarriage rate of patients with RPL and improve the clinical pregnancy rate of patients with RIF. Our data suggested that NICS could be used as a diagnostic test in clinical practice.

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Endometrial stromal cell proteome mapping in repeated implantation failure and recurrent pregnancy loss cases and fertile women

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2018.11.022 ◽

2019 ◽

Vol 38 (3) ◽

pp. 442-454 ◽

Cited By ~ 4

Author(s):

Lien Dhaenens ◽

Sylvie Lierman ◽

Laura De Clerck ◽

Elisabeth Govaert ◽

Dieter Deforce ◽

...

Keyword(s):

Pregnancy Loss ◽

Stromal Cell ◽

Recurrent Pregnancy Loss ◽

Implantation Failure ◽

Endometrial Stromal Cell ◽

Repeated Implantation Failure ◽

Cell Proteome ◽

Fertile Women

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Tacrolimus Improves the Implantation Rate in Patients with Elevated Th1/2 Helper Cell Ratio and Repeated Implantation Failure (RIF)

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1056-3148 ◽

2020 ◽

Vol 80 (08) ◽

pp. 851-862

Author(s):

Zahra Bahrami-Asl ◽

Laya Farzadi ◽

Amir Fattahi ◽

Mehdi Yousefi ◽

Alicia Quinonero ◽

...

Keyword(s):

Implantation Rate ◽

Live Birth Rate ◽

Immunosuppressive Drug ◽

Implantation Failure ◽

T Helper ◽

T Helper 1 ◽

Repeated Implantation Failure ◽

T Helper 2 ◽

Tacrolimus Therapy ◽

Ifn Γ

Abstract Introduction An abnormal endometrial immune response is involved in the pathogenesis of repeated implantation failure (RIF), so we investigated the effectiveness of tacrolimus treatment on the endometrium of RIF patients. Materials and Methods Ten RIF patients with elevated T-helper 1/T-helper 2 (Th1/Th2) cell ratios were recruited into a clinical study. The expression of p53, leukemia inhibitory factor (LIF), interleukin (IL)-4, IL-10, IL-17, and interferon gamma (IFN-γ) in the endometrium of patients with and without tacrolimus treatment and the association of these factors with assisted reproductive technology (ART) outcomes were investigated. Results Tacrolimus significantly increased the expression of LIF, IL-10, and IL-17 and decreased the expression of IL-4, IFN-γ, and the IFN-γ/IL-10 ratio in RIF patients. Tacrolimus treatment resulted in an implantation rate of 40%, a clinical pregnancy rate of 50%, and a live birth rate of 35% in RIF patients with elevated Th1/Th2 ratios who had previously failed to become pregnant despite at least three transfers of embryos. We also found a significant positive correlation between IL-10 levels and the implantation rate. Conclusions Our findings suggest that RIF patients with a higher Th1/Th2 ratio could be candidates for tacrolimus therapy and that this immunosuppressive drug could be acting through upregulation of LIF, IL-10, and IL-17.

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