Mei Jie, Yan Yuan, Jiang Ruyv, Zhu Ying-Chun, Ding Lijun, Sun Haixiang
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.
Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China.
Am J Reprod Immunol. 2022 May;87(5):e13529. doi: 10.1111/aji.13529. Epub 2022 Mar 6.
Intrauterine administration of autologous peripheral blood mononuclear cells (PBMCs) or human chorionic gonadotropin (hCG) has been proposed to facilitate embryo implantation, while its effect on clinical outcome of women with previous implantation failure (RIF) in frozen/thawed embryo transfer (FET) cycles is still unclear.
A total 523 patients having not experienced successful clinical pregnancy were enrolled in our study, including 207 repeat implantation failure (RIF) patients, and 316 patients with previous implantation failures but failed to meet the diagnostic criteria for RIF (non-RIF). Autologous PBMCs were cultured with hCG for 4 h in the hCG-activated PBMC-treated group (n = 73 in RIF patients, n = 112 in non-RIF patients), and then intrauterine administered 2 days before FET. In the hCG-treated group (n = 67 in RIF patients, n = 100 in non-RIF patients), recombinant hCG was administered 2 days before FET. The control group (n = 67 in RIF patients, n = 104 in non-RIF patients) underwent FET without intrauterine administration.
In RIF patients, the clinical pregnancy rate of the above three groups are 56.16%, 53.73%, and 43.28%, respectively (p = .276). The implantation rate and live birth rate showed no significant differences (p > .05). For non-RIF patients, higher clinical pregnancy rate was also seen in PBMC intrauterine group (57.15%) and hCG intrauterine group (58.00%) than controls (50.96%) but without statistical significance. There were no significant differences of implantation rate and live birth rate (p > .05).
Intrauterine administration of hCG-activated PBMC and hCG did not improve clinical outcomes for both RIF and non-RIF patients before FET embryo transfer.
有人提出宫腔内注射自体外周血单个核细胞（PBMC）或人绒毛膜促性腺激素（hCG）可促进胚胎着床，但其对既往有种植失败（RIF）的女性在冻融胚胎移植（FET）周期中的临床结局的影响仍不明确。
本研究共纳入523例未经历过临床妊娠成功的患者，包括207例反复种植失败（RIF）患者和316例既往有种植失败但未达到RIF诊断标准的患者（非RIF）。在hCG激活的PBMC治疗组（RIF患者73例，非RIF患者112例）中，将自体PBMC与hCG培养4小时，然后在FET前2天进行宫腔内注射。在hCG治疗组（RIF患者67例，非RIF患者100例）中，在FET前2天给予重组hCG。对照组（RIF患者67例，非RIF患者104例）进行FET但不进行宫腔内注射。
在RIF患者中，上述三组的临床妊娠率分别为56.16%、53.73%和43.28%（p = 0.276）。着床率和活产率无显著差异（p>0.05）。对于非RIF患者，PBMC宫腔内注射组（57.15%）和hCG宫腔内注射组（58.00%）的临床妊娠率也高于对照组（50.96%），但无统计学意义。着床率和活产率无显著差异（p>0.05）。
在FET胚胎移植前，宫腔内注射hCG激活的PBMC和hCG均未改善RIF和非RIF患者的临床结局。
