title: Uterine immune profiling for increasing live birth rate: A one-to-one matched cohort study.
abstract: Embryo implantation remains the main limiting factor in IVF/ICSI program. Endometrial immune remodeling events begin before implantation and are a vital process for pregnancy, preparing future maternal immune tolerance and regulating the placentation process.
  
  
  
  Between 2012 and 2014, 193 patients (analyzed group) enrolled in our IVF program benefitted of an endometrial immune profiling to determine if their uterus was immunologically ready to accept an embryo and, if not, the specific immune mechanisms involved. Subsequently, they had an effective embryo transfer (ET) with personalization of their treatments if an immune deregulation has been diagnosed. Each analyzed patient was paired to the closest patient included in the IVF program according to biological criteria (age, number of mature oocytes, stage and number of transferred embryo), which had no endometrial immune profiling (193 patients, non-analyzed group).
  
  
  
  78% of analyzed patients had a uterine immune dysregulation and therefore care personalization. Their corresponding live birth rate (LBR) was twice higher than observed in the matched control group with conventional cares (30.5% versus 16.6%, OR: 2.2 [1.27-3.83] p=0.004) with a simultaneous drastic reduction of miscarriages per initiated pregnancy (17.9% versus 43.2%, OR: 0.29 [0.12-0.71], p=0.005). 22% of analyzed patients had no dysregulation. They did not differ from their matched controls for LBR and miscarriages.
  
  
  
  Uterine immune profiling enables an integrated approach of infertility that includes endometrial immunity as a key factor in planning personalized IVF/ICSI treatments. Personalization of treatment according to the woman's uterine immune balance produced a very significantly higher LBR.
authors.affiliation: Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France; MatriceLAB Innove SARL, Saint-Louis Hospital, Pavillon Bazin, 1 Avenue Claude Vellefaux, 75010 Paris, France; Institut National de Santé et de Recherche Médicale, INSERM UMR-976, Saint-Louis Hospital, Research Center, 1 Avenue Claude Vellefaux, 75010, Paris, France; Paris Diderot University, Paris VII, 1 Avenue Claude Vellefaux, 75010 Paris, France. Electronic address: nathalie-ledee@orange.fr.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lédée
authors.affiliation: Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Prat-Ellenberg
authors.affiliation: MatriceLAB Innove SARL, Saint-Louis Hospital, Pavillon Bazin, 1 Avenue Claude Vellefaux, 75010 Paris, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Chevrier
authors.affiliation: Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Balet
authors.affiliation: Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Simon
authors.affiliation: Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France.
authors.forename: Clarisse
authors.initials: C
authors.lastname: Lenoble
authors.affiliation: Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France.
authors.forename: Elie El
authors.initials: EE
authors.lastname: Irani
authors.affiliation: Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Bouret
authors.affiliation: Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Cassuto
authors.affiliation: Plateforme AP-HP, Saint-Louis Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Vitoux
authors.affiliation: MatriceLAB Innove SARL, Saint-Louis Hospital, Pavillon Bazin, 1 Avenue Claude Vellefaux, 75010 Paris, France.
authors.forename: Katia
authors.initials: K
authors.lastname: Vezmar
authors.affiliation: Institut National de Santé et de Recherche Médicale, INSERM UMR-976, Saint-Louis Hospital, Research Center, 1 Avenue Claude Vellefaux, 75010, Paris, France; Paris Diderot University, Paris VII, 1 Avenue Claude Vellefaux, 75010 Paris, France.
authors.forename: Armand
authors.initials: A
authors.lastname: Bensussan
authors.affiliation: Institut National de Santé et de Recherche Médicale, INSERM UMR-976, Saint-Louis Hospital, Research Center, 1 Avenue Claude Vellefaux, 75010, Paris, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Chaouat
authors.affiliation: MatriceLAB Innove SARL, Saint-Louis Hospital, Pavillon Bazin, 1 Avenue Claude Vellefaux, 75010 Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Petitbarat
mesh_terms: D000022:Abortion, Spontaneous / Q000175:diagnosis / Q000628:therapy*; D000328:Adult; D019002:CD56 Antigen / Q000378:metabolism; D015331:Cohort Studies; D000074049:Cytokine TWEAK / Q000235:genetics / Q000378:metabolism; D010064:Embryo Implantation; D004717:Endometrium / Q000276:immunology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D019409:Interleukin-15 / Q000235:genetics / Q000378:metabolism; D020382:Interleukin-18 / Q000235:genetics / Q000378:metabolism; D007694:Killer Cells, Natural / Q000276:immunology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D000074050:TWEAK Receptor / Q000235:genetics / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D019002:CD56 Antigen; D000074049:Cytokine TWEAK; D019409:Interleukin-15; D020382:Interleukin-18; C000613297:TNFRSF12A protein, human; C109743:TNFSF12 protein, human; D000074050:TWEAK Receptor
keywords: Embryo implantation; Endometrium; IVF/ICSI; Repeated implantation failures; Uterine receptivity