Intrauterine administration of autologous peripheral blood mononuclear cells increases clinical pregnancy rates in frozen/thawed embryo transfer cycles of patients with repeated implantation failure.
Intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) activated by HCG in vitro are reported to improve implantation rates in patients with repeated failure of IVF-ET. In this study, we examined the effects of intrauterine administration of freshly isolated PBMC on clinical pregnancy and the implantation rates of patients who received frozen/thawed embryo transfer by prospective cohort study. Patients who had not achieved a successful pregnancy despite at least one or more IVF-ET sessions were enrolled in this study (n = 253, 253 cycles). Based on the patient's treatment preferences, PBMC were freshly isolated from each patient and then administered to the intrauterine cavity of that patient. Frozen/thawed embryo transfer was performed and the success of implantation in the PBMC-treated group (n = 83, 83 cycles) was compared with that in the non-treated control groups (n = 170, 170 cycles). There were no significant differences in the clinical pregnancy rate (34.9% vs. 32.9%), implantation rate (21.6% vs. 21.1%) and live birth delivery rate (21.7% vs. 21.8%) between PBMC-treated and non-treated groups. However, when the analyses were restricted to patients who had three or more implantation failures, the clinical pregnancy rate and the implantation rate in the PBMC-treated group (42.1% and 25.0%, p<0.05; n = 19 and 32, respectively) were significantly higher than those in the non-treated group (16.7% and 9.4%, p<0.05; n = 36 and 64, respectively). These findings indicate that intrauterine administration of autologous PBMC freshly isolated from patients, effectively improves embryo implantation in patients with three or more IVF failures.
Center for Reproductive Medicine, Miyake Clinic, 369-8 Ofuku, Minami-ku, Okayama 701-0204, Japan. repro036@ms6.megaegg.ne.jp
Osamu
O
Okitsu
Machiko
M
Kiyokawa
Takashi
T
Oda
Kaoru
K
Miyake
Yukiyasu
Y
Sato
Hiroshi
H
Fujiwara
D000328:Adult; D001804:Blood Transfusion, Autologous; D001805:Blood Transfusion, Intrauterine; D015331:Cohort Studies; D015925:Cryopreservation; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012008:Recurrence; D017211:Treatment Failure