Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo, Japan.
Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Am J Reprod Immunol. 2021 Sep;86(3):e13429. doi: 10.1111/aji.13429. Epub 2021 Apr 20.
We aimed to assess whether an imbalance of T-helper (Th) 1 and Th2 cells contributes to implantation failure and pregnancy loss.
In this cross-sectional study, 197 consecutive patients with a history of repeated implantation failure (RIF) after three or more embryo transfer (ET) cycles and/or recurrent pregnancy loss (RPL) after two or more clinical pregnancy losses underwent Th cell testing. After excluding 42 women aged ≥44 and 9 with vitamin D supplementation, we recruited 146 women including 79 with RIF and 81 with RPL. Fourteen women had a history of both RIF and RPL. We also recruited 45 fertile women and 40 general infertile women without a history of in vitro fertilization treatment. This study was approved by the local ethics committee.
There was no significant difference in IFN-γ-producing Th1 and IL-4-producing Th2 cell levels between the fertile and general infertile women, but Th1 cell levels and the Th1/Th2 cell ratio were significantly higher in the women with ≥4 ET cycles and ≥2 pregnancy losses than in the fertile and general infertile women. In the general infertile women, the total livebirth rates including natural conception after two ET cycles in the normal and high Th1/Th2 groups (Th1/Th2 <11.8 and ≥11.8, respectively) were 66.7% and 87.5%, respectively (p = .395).
A high Th1/Th2 cell ratio was linked to ≥4 implantation failure cycles and ≥2 pregnancy losses but not to general infertility.
我们旨在评估辅助性 T 细胞（Th）1 和 Th2 细胞失衡是否与着床失败和妊娠丢失有关。
在这项横断面研究中，对 197 例经历过 3 次以上胚胎移植（ET）周期反复着床失败（RIF）和/或 2 次以上临床妊娠丢失后反复妊娠丢失（RPL）的连续患者进行了 Th 细胞检测。排除 42 名年龄≥44 岁和 9 名补充维生素 D 的女性后，我们招募了 146 名女性，其中 79 名 RIF 和 81 名 RPL。14 名女性同时有 RIF 和 RPL 病史。我们还招募了 45 名生育力正常的女性和 40 名无体外受精治疗史的一般不孕女性。本研究得到了当地伦理委员会的批准。
在生育力正常和一般不孕女性中，IFN-γ 产生 Th1 细胞和 IL-4 产生 Th2 细胞水平无显著差异，但≥4 个 ET 周期和≥2 次妊娠丢失的女性 Th1 细胞水平和 Th1/Th2 细胞比值明显高于生育力正常和一般不孕女性。在一般不孕女性中，两个 ET 周期后自然受孕的总活产率（Th1/Th2<11.8 和≥11.8 的正常和高 Th1/Th2 组）分别为 66.7%和 87.5%（p=0.395）。
高 Th1/Th2 细胞比值与≥4 个着床失败周期和≥2 次妊娠丢失有关，而与一般不孕无关。
