Intrauterine Administration of Treated PBMC Prior Frozen/Thawed Embryo Transfer Improves Pregnancy Outcomes in Patients with Repeated Implantation Failures

Background: Implantation success is mainly dependent on local immune-tolerance mechanisms involving a spectrum of cytokines, interleukines and growth factors. The aim of this study was to evaluate clinically the effectiveness of intrauterine administration of treated PBMC prior frozen/thawed embryo transfer for RIF patients undergoing IVF program. Methods: this study is a randomized clinical trial, including 250 couples (PBMC-test, n= 122 and Control, n= 128) who being part of Frozenthawed embryo transfer cycles. In tread group a blood sample is scheduled five days before frozen-thawed embryo transfer and PBMC was isolated using a separation protocol based on Ficoll. PBMC is well prepared after a culture for 48-72 h. Then, 0.4ml of cultured PBMC transferred to the patient of PBMC group, in uterus 2-3 days before embryo transfer. Results: clinical pregnancy rate was increase from 23.4% for control group to 34.4% for PBMC group but this different wasn’t statistically significant (p=0.07, chi-square). When we limited our analysis to patient with ≥3 RIF (n=138), there were a significant difference in clinical pregnancy rate (38.6% vs 19.8%) between PBMC and control groups (p=0.02, chi-square). Conclusions: The findings of this study indicate that the use of PBMC can be an effective treatment for infertile patients with RIF.

Keywords:

Peripheral blood mononuclear cells , Corticotropin-releasing hormone , In vitro fertilization , Embryo Implantation , Pregnancy rates