The Effect of Intrauterine Autologous Peripheral Blood Mononuclear Cells (PBMCs) Administration in Modulating the Immunologic Profile Aberrations in Repeated Implantation Failure (RIF) Women.

PURPOSE: Considering the immune-related etiology of RIF, administration of an immunomodulatory approach such as autologous PBMCs seems to be helpful in modifying the dysregulated immune responses.

METHODS

100 RIF women were divided into the PBMC receiving and the control group. Blood sampling was conducted 48 h before and 2 weeks after PBMC administration. The frequency of Th17, Treg, and NK cells, the expression level of related transcription factors and miRNAs, and the concentration of inflammatory and anti-inflammatory cytokines were evaluated pre- and post-treatment. Pregnancy outcome including pregnancy, live birth, and miscarriage rates were also evaluated.

RESULTS

PBMC therapy significantly elevated the frequency of Th17 and NK cells (p = 0.0035 and 0.0013, respectively) and the expression of RORγt (p < 0.0001), in comparison with pre-treatment, while the frequency of Treg cells (p = 0.0063) and the expression of FoxP3 and PTEN were decreased post treatment. The serum concentration of IL-1β, IL-17, and TNF-α was increased, while IL-10 and TGF-β were reduced post-treatment when compared to pre-treatment. Pregnancy and live birth rates were significantly higher in the PBMC-treated group in comparison with routine treatment.

CONCLUSION

Intrauterine administration of autologous PBMCs may be helpful in treating RIF patients, especially those with decreased inflammatory cells and mediators in the implantation process.