Wang Lei, Ji Mengxia, Fu Xiaohua, Zhu Lifen, Duan Ting, Ni Wanmao
Cancer Center, Department of Pathology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Center for Reproductive Medicine, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
J Reprod Immunol. 2025 Aug;170:104539. doi: 10.1016/j.jri.2025.104539. Epub 2025 May 16.
Successful implantation during frozen embryo transfer (FET) is influenced by multiple factors. However, the role of endometrial immune cells in predicting FET outcomes remains unclear, particularly in an age-independent context. This study aimed to develop a prediction model based on endometrial immune cell characteristics to predict FET outcomes regardless of patient age. We analyzed 78 patients undergoing FET (2021-2023), categorized into successful FET and Recurrent Implantation Failure (RIF) groups. After age-matching via Propensity Score Matching, endometrial immune cell profiles were compared between groups. Key predictors identified through Elastic Net analysis were used to develop a CatBoost prediction model. Before age matching, significant differences between groups were observed in age, neutrophil, monocyte, lymphocyte, and CD56CD16NK levels. After age matching, only lymphocyte and B cell levels remained significantly different. The model using lymphocytes, CD56CD16 NK cells, and B cells as predictors achieved ROC AUC scores of 0.88 (age-matched test set) and 0.84 (full dataset), with 0.80 accuracy. CD56CD16 NK cells showed strong positive correlation with RIF. This study reveals a novel association between CD56CD16 NK cells and recurrent implantation failure. The age-independent prediction model demonstrates the potential of immune cell profiling for predicting FET outcomes and may guide personalized reproductive medicine approaches.
冷冻胚胎移植（FET）期间的成功着床受多种因素影响。然而，子宫内膜免疫细胞在预测FET结局中的作用仍不明确，尤其是在与年龄无关的情况下。本研究旨在基于子宫内膜免疫细胞特征开发一种预测模型，以预测无论患者年龄的FET结局。我们分析了78例接受FET的患者（2021 - 2023年），分为FET成功组和反复着床失败（RIF）组。通过倾向得分匹配进行年龄匹配后，比较两组之间的子宫内膜免疫细胞谱。通过弹性网络分析确定的关键预测因子用于开发CatBoost预测模型。在年龄匹配前，两组在年龄、中性粒细胞、单核细胞、淋巴细胞和CD56CD16NK水平上存在显著差异。年龄匹配后，仅淋巴细胞和B细胞水平仍存在显著差异。使用淋巴细胞、CD56CD16 NK细胞和B细胞作为预测因子的模型在年龄匹配测试集上的ROC AUC得分为0.88，在完整数据集中为0.84，准确率为0.80。CD56CD16 NK细胞与RIF呈强正相关。本研究揭示了CD56CD16 NK细胞与反复着床失败之间的新关联。与年龄无关的预测模型证明了免疫细胞谱分析在预测FET结局方面的潜力，并可能指导个性化生殖医学方法。
