The uterine immune profile: A method for individualizing the management of women who have failed to implant an embryo after IVF/ICSI
- PMID: 32971456
- DOI: 10.1016/j.jri.2020.103207
The uterine immune profile: A method for individualizing the management of women who have failed to implant an embryo after IVF/ICSI
Abstract
A unique endometrial immune reaction should occur to promote the human embryo implantation. We postulated that an immune disequilibrium may impact the initial dialogue between the mother and her embryo. In 2012, we set a method of uterine immune profiling for patients with unexplained repeated implantation failures (RIF). The method documents the local Th-1/ Th-2 equilibrium and the recruitment and state of maturation/activation of uNK cells. In function of the disequilibrium observed, personalization of assisted reproductive treatments was suggested. As the concept of personalization in function of the uterine immune profile had never been proposed, a large cohort study and a controlled cohort study were first conducted in RIF patients. 80 % of the RIF patients showed a local disequilibrium if compared to fertile controls. The local disequilibrium was identified in 3 categories: over-immune activation in 45 %, low- local immune activation in 25 % and mixed profile in 10 %. Personalization of treatments in function of the immune profile allowed to restore a live birth rate by 40 % at the following embryo transfer. RIF patients with endometriosis show some particularities regarding their immune profiles. We also suggested that immunotherapy (corticoids, intralipids) may have targeted indications based on a better understanding of the immune type of disequilibrium documented. Personalization of treatments for RIF patients seems to be essential to promote the subsequent live birth rate. The endometrial immune profiling is an innovative method aiming to detect a local immune disequilibrium and, if present, to test preventively its correction under treatment.
Keywords: Cytokines, pregnancy; IVF; Immunology, endometrium; Implantation failures.
Copyright © 2020. Published by Elsevier B.V.
Similar articles
-
Determining diagnostic criteria and cause of recurrent implantation failure.Curr Opin Obstet Gynecol. 2020 Jun;32(3):198-204. doi: 10.1097/GCO.0000000000000620. Curr Opin Obstet Gynecol. 2020. PMID: 32251092 Review.
-
The uterine immunological changes may be responsible for repeated implantation failure.J Reprod Immunol. 2020 Apr;138:103080. doi: 10.1016/j.jri.2020.103080. Epub 2020 Jan 23. J Reprod Immunol. 2020. PMID: 32120158
-
What is the prognosis for a live birth after unexplained recurrent implantation failure following IVF/ICSI?Hum Reprod. 2019 Oct 2;34(10):2044-2052. doi: 10.1093/humrep/dez120. Hum Reprod. 2019. PMID: 31621857
-
Intralipid® may represent a new hope for patients with reproductive failures and simultaneously an over-immune endometrial activation.J Reprod Immunol. 2018 Nov;130:18-22. doi: 10.1016/j.jri.2018.09.050. Epub 2018 Sep 24. J Reprod Immunol. 2018. PMID: 30286362
-
Repeated implantation failure: clinical approach.Fertil Steril. 2012 May;97(5):1039-43. doi: 10.1016/j.fertnstert.2012.03.010. Epub 2012 Mar 30. Fertil Steril. 2012. PMID: 22464086 Review.
Cited by
-
Endometrial immune profiling as a new tool for preconceptional assessment in patients with systemic autoimmune diseases.Front Immunol. 2024 Jan 5;14:1334231. doi: 10.3389/fimmu.2023.1334231. eCollection 2023. Front Immunol. 2024. PMID: 38250081 Free PMC article. No abstract available.
-
Endometrial biopsy performed before the first in vitro fertilization does not impact the early pregnancy rate.Sci Rep. 2024 Jan 11;14(1):1153. doi: 10.1038/s41598-023-50715-y. Sci Rep. 2024. PMID: 38212636 Free PMC article. Clinical Trial.
-
The Pathological Role of miRNAs in Endometriosis.Biomedicines. 2023 Nov 17;11(11):3087. doi: 10.3390/biomedicines11113087. Biomedicines. 2023. PMID: 38002087 Free PMC article. Review.
-
The Neglected Uterine NK Cells/Hamperl Cells/Endometrial Stromal Granular Cell, or K Cells: A Narrative Review from History through Histology and to Medical Education.Int J Mol Sci. 2023 Aug 11;24(16):12693. doi: 10.3390/ijms241612693. Int J Mol Sci. 2023. PMID: 37628873 Free PMC article. Review.
-
The Next Frontier in ART: Harnessing the Uterine Immune Profile for Improved Performance.Int J Mol Sci. 2023 Jul 11;24(14):11322. doi: 10.3390/ijms241411322. Int J Mol Sci. 2023. PMID: 37511080 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Research Materials