Intrauterine administration of autologous peripheral blood mononuclear cells increases clinical pregnancy rates in frozen/thawed embryo transfer cycles of patients with repeated implantation failure
Intrauterine administration of autologous peripheral blood mononuclear cells increases clinical pregnancy rates in frozen/thawed embryo transfer cycles of patients with repeated implantation failure
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DOI：
10.1016/j.jri.2011.07.001
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发表时间：
2011-12-01
影响因子：
3.4
通讯作者：
Fujiwara, Hiroshi
中科院分区：
文献类型：
--
作者：
Okitsu, Osamu;Kiyokawa, Machiko;Fujiwara, Hiroshi
体外HCG激活的自体外周血单个核细胞（PBMC）宫内给药可提高IVF-ET反复失败患者的着床率。在这项研究中，我们通过前瞻性队列研究来检查宫内施用新鲜分离的PBMC对接受冷冻/解冻胚胎移植的患者的临床妊娠和种植率的影响。尽管至少进行了一次或多次IVF-ET治疗但未成功妊娠的患者入组本研究（n = 253，253个周期）。基于患者的治疗偏好，从每个患者新鲜分离PBMC，然后施用至该患者的子宫腔内。进行冷冻/解冻胚胎移植，并将PBMC治疗组（n = 83，83个周期）的植入成功率与未治疗对照组（n = 170，170个周期）的植入成功率进行比较。PBMC给药组和非给药组的临床妊娠率（34.9% vs. 32.9%）、着床率（21.6% vs. 21.1%）和活产率（21.7% vs. 21.8%）无显著差异。然而，当分析仅限于三次或三次以上着床失败的患者时，PBMC治疗组的临床妊娠率和着床率（42.1%和25.0%，P < 0.05; n = 19和32）显著高于未治疗组（分别为16.7%和9.4%，p < 0.05; n = 36和64）。这些发现表明，子宫内施用从患者新鲜分离的自体PBMC有效地改善了三次或三次以上IVF失败的患者的胚胎植入。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) activated by HCG in vitro are reported to improve implantation rates in patients with repeated failure of IVF-ET. In this study, we examined the effects of intrauterine administration of freshly isolated PBMC on clinical pregnancy and the implantation rates of patients who received frozen/thawed embryo transfer by prospective cohort study. Patients who had not achieved a successful pregnancy despite at least one or more IVF-ET sessions were enrolled in this study (n = 253,253 cycles). Based on the patient's treatment preferences, PBMC were freshly isolated from each patient and then administered to the intrauterine cavity of that patient. Frozen/thawed embryo transfer was performed and the success of implantation in the PBMC-treated group (n = 83, 83 cycles) was compared with that in the non-treated control groups (n = 170, 170 cycles). There were no significant differences in the clinical pregnancy rate (34.9% vs. 32.9%), implantation rate (21.6% vs. 21.1%) and live birth delivery rate (21.7% vs. 21.8%) between PBMC-treated and non-treated groups. However, when the analyses were restricted to patients who had three or more implantation failures, the clinical pregnancy rate and the implantation rate in the PBMC-treated group (42.1% and 25.0%, p < 0.05; n = 19 and 32, respectively) were significantly higher than those in the non-treated group (16.7% and 9.4%, p < 0.05; n = 36 and 64, respectively). These findings indicate that intrauterine administration of autologous PBMC freshly isolated from patients, effectively improves embryo implantation in patients with three or more IVF failures. (C) 2011 Elsevier Ireland Ltd. All rights reserved.