title: Intrauterine insemination of cultured peripheral blood mononuclear cells prior to embryo transfer improves clinical outcome for patients with repeated implantation failures.
abstract: 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.
authors.affiliation: Anfa Fertility Center,Privante Clinic of Human Reproduction and Endoscopic Surgery,Casablanca,Morocco.
authors.forename: Aicha
authors.initials: A
authors.lastname: Madkour
authors.affiliation: Biochemistry and Immunology Laboratory,Mohammed V University,Faculty of Sciences,BP 1014,Avenue Ibn Batouta Agdal,Rabat,Morocco.
authors.forename: Nouzha
authors.initials: N
authors.lastname: Bouamoud
authors.affiliation: Anfa Fertility Center,Privante Clinic of Human Reproduction and Endoscopic Surgery,Casablanca,Morocco.
authors.forename: Noureddine
authors.initials: N
authors.lastname: Louanjli
authors.affiliation: Anfa Fertility Center,Privante Clinic of Human Reproduction and Endoscopic Surgery,Casablanca,Morocco.
authors.forename: Ismail
authors.initials: I
authors.lastname: Kaarouch
authors.affiliation: Reproductive Biology and Medical Cytogenetics Laboratory,Regional University Hospital & School of Medicine,Picardie University Jules Verne,Amiens,France.
authors.forename: Henri
authors.initials: H
authors.lastname: Copin
authors.affiliation: Reproductive Biology and Medical Cytogenetics Laboratory,Regional University Hospital & School of Medicine,Picardie University Jules Verne.Amiens.France.
authors.forename: Moncef
authors.initials: M
authors.lastname: Benkhalifa
authors.affiliation: Anfa Fertility Center,Privante Clinic of Human Reproduction and Endoscopic Surgery,Casablanca,Morocco.
authors.forename: Omar
authors.initials: O
authors.lastname: Sefrioui
mesh_terms: D000328:Adult; D002478:Cells, Cultured; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000379:methods*; D004717:Endometrium; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D017211:Treatment Failure; D016896:Treatment Outcome; D014599:Uterus
keywords: Endometrium immuno-modulation; In vitro fertilization and fresh embryo transfer; Peripheral blood mononuclear cells; Repeated implantation failure