#371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation Failures

Background and Aim: Recurrent implantation failures (RIF) remain always a strong problem for all IVF teams. Our ART Center started in 2015 and quickly we wanted to focus on implantation failure. After 2 or 3 embryo transfers without pregnancy, guidelines provide to perform exams such as karyotypes,...

Full description

Bibliographic Details
Main Authors: Chien Nguyen, Xuyen Nguyen, Ly Nguyen
Format: Article
Language:English
Published: World Scientific Publishing 2023-12-01
Series:Fertility & Reproduction
Online Access:https://www.worldscientific.com/doi/10.1142/S266131822374345X
_version_ 1797236981872197632
author Chien Nguyen
Xuyen Nguyen
Ly Nguyen
author_facet Chien Nguyen
Xuyen Nguyen
Ly Nguyen
author_sort Chien Nguyen
collection DOAJ
description Background and Aim: Recurrent implantation failures (RIF) remain always a strong problem for all IVF teams. Our ART Center started in 2015 and quickly we wanted to focus on implantation failure. After 2 or 3 embryo transfers without pregnancy, guidelines provide to perform exams such as karyotypes, Anti phospholipid, thrombophilia, uterine Doppler, hysteroscopy, endometrial biopsy with CD 136, laparoscopy, sperm DNA Fragmentation. However, a large part of these failures remains unexplained. Following the studies performed in France by N. Lédée in 2013, this study evaluates the results of a new exploration based on immunological analysis of endometrial receptivity. Methods: This study is proposed, after other explorations already done, for patients with 6 or more embryos D3 or 3 embryos D5 transferred without pregnancy. Such an analysis is achieved on endometrial biopsy performed in middle luteal phase and sent to MatriceLab (Paris) Immunological exploration is based on uNK count (uterine Natural Killer cells) and cytokines expression. According to these parameters, “individualized” care is proposed to patient for next embryo transfers to correct the disorder identified by analysis. Results: From 2016 to 2020, 114 biopsies have been performed and sent to MatriceLab. 112 were suitable for analysis. According with results, 4 main profiles have been isolated: Normal immunity (22,3%) Dysregulation immunity (77,7%). Low local immune activation (25%). Over local immune activation (40,2%). “Mix” profile (12,5%) 95 patients have been performing FET following the analysis. Mean age 32.6 ±3.6 years. Mean number of transfers before biopsy 3.9 ±1.6. Mean number of embryos previously transferred 9.6 ±4.4. Deliveries in normal immunity group: 33% (n=6). Deliveries in dysregulation group treated with adapted protocol: 53,2% (n=40) Conclusions: This pregnancy rate is much better than usual pregnancy rate expected after six embryos D3 or three embryos D5 transferred without pregnancy.
first_indexed 2024-04-24T17:12:30Z
format Article
id doaj.art-29dd21b4d7004137bb4528338058ed9b
institution Directory Open Access Journal
issn 2661-3182
2661-3174
language English
last_indexed 2024-04-24T17:12:30Z
publishDate 2023-12-01
publisher World Scientific Publishing
record_format Article
series Fertility & Reproduction
spelling doaj.art-29dd21b4d7004137bb4528338058ed9b2024-03-28T07:54:19ZengWorld Scientific PublishingFertility & Reproduction2661-31822661-31742023-12-01050461161110.1142/S266131822374345X#371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation FailuresChien Nguyen0Xuyen Nguyen1Ly Nguyen2Vinmec International Hospital, Hanoi, Viet NamVinmec International Hospital, Hanoi, Viet NamVinmec International Hospital, Hanoi, Viet NamBackground and Aim: Recurrent implantation failures (RIF) remain always a strong problem for all IVF teams. Our ART Center started in 2015 and quickly we wanted to focus on implantation failure. After 2 or 3 embryo transfers without pregnancy, guidelines provide to perform exams such as karyotypes, Anti phospholipid, thrombophilia, uterine Doppler, hysteroscopy, endometrial biopsy with CD 136, laparoscopy, sperm DNA Fragmentation. However, a large part of these failures remains unexplained. Following the studies performed in France by N. Lédée in 2013, this study evaluates the results of a new exploration based on immunological analysis of endometrial receptivity. Methods: This study is proposed, after other explorations already done, for patients with 6 or more embryos D3 or 3 embryos D5 transferred without pregnancy. Such an analysis is achieved on endometrial biopsy performed in middle luteal phase and sent to MatriceLab (Paris) Immunological exploration is based on uNK count (uterine Natural Killer cells) and cytokines expression. According to these parameters, “individualized” care is proposed to patient for next embryo transfers to correct the disorder identified by analysis. Results: From 2016 to 2020, 114 biopsies have been performed and sent to MatriceLab. 112 were suitable for analysis. According with results, 4 main profiles have been isolated: Normal immunity (22,3%) Dysregulation immunity (77,7%). Low local immune activation (25%). Over local immune activation (40,2%). “Mix” profile (12,5%) 95 patients have been performing FET following the analysis. Mean age 32.6 ±3.6 years. Mean number of transfers before biopsy 3.9 ±1.6. Mean number of embryos previously transferred 9.6 ±4.4. Deliveries in normal immunity group: 33% (n=6). Deliveries in dysregulation group treated with adapted protocol: 53,2% (n=40) Conclusions: This pregnancy rate is much better than usual pregnancy rate expected after six embryos D3 or three embryos D5 transferred without pregnancy.https://www.worldscientific.com/doi/10.1142/S266131822374345X
spellingShingle Chien Nguyen
Xuyen Nguyen
Ly Nguyen
#371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation Failures
Fertility & Reproduction
title #371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation Failures
title_full #371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation Failures
title_fullStr #371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation Failures
title_full_unstemmed #371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation Failures
title_short #371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation Failures
title_sort 371 immunological analysis of endometrial receptivity a new hope for patients with recurrent implantation failures
url https://www.worldscientific.com/doi/10.1142/S266131822374345X
work_keys_str_mv AT chiennguyen 371immunologicalanalysisofendometrialreceptivityanewhopeforpatientswithrecurrentimplantationfailures
AT xuyennguyen 371immunologicalanalysisofendometrialreceptivityanewhopeforpatientswithrecurrentimplantationfailures
AT lynguyen 371immunologicalanalysisofendometrialreceptivityanewhopeforpatientswithrecurrentimplantationfailures