Endometrial immune profiling and precision therapy increase live birth rate after embryo transfer: a randomised controlled trial

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: Feb. 24, 2025

Despite advancements in assisted reproductive treatments, 70% of transferred embryos fail to implant successfully, yielding significant personal and global repercussions. One promising avenue research is take into account the individual's immune uterine profile order tailor treatment optimise outcomes. This randomised controlled trial represents initial exploration consequences disregarding state environment infertile women embarking on IVF/ICSI. open two-arm included IVF patients, with assessment endometrial precision therapy before embryo transfer (ET). 493 patients were enrolled from October 2015 February2023. Endometrial biopsies collected during mid-luteal phase. profiling involves analysis cytokine biomarkers endometrium. If an dysregulation was diagnosed, a computerised randomisation assigned either conventional ET (disregarding profile) or personalised (with adapted profile). The primary focussed demonstrating superiority treatments using modified intent-to-treat population (mITT), excluding without ET. endpoint live birth rate (LBR) following first attempt Among population, 78% had randomised. mITT showed increase LBR care compared (29.7% vs. 41.4%; OR: 1.68 [1.04-2.73], p=0.036). positive impact particularly noticeable morphologically suboptimal (LBR: 21.2% 39.6%; 2.12 [1.02-4.41]) those history two more failed 23.4% 48.1%; 3.03 [1.17-7.85]). data should be interpreted caution due inherent structural limitations human trials. Generalising empowering our findings would rely replication trials by independent teams possibly integrating usage optimised quality PGT-A. regulation emerges as one leading innovative strategies facilitate implantation enhance overall performance therapies (ART). Based these findings, could become essential part routine ART practice. clinicaltrials.gov, identifier NCT02262117.

Language: Английский

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How Insects Balance Reproductive Output and Immune Investment

Insects, Journal Year: 2025, Volume and Issue: 16(3), P. 311 - 311

Published: March 17, 2025

Insects face the constant challenge of balancing energy allocation between reproduction and immune responses, both which are highly energy-demanding processes. Immune challenges frequently result in decreased fecundity, reduced egg viability, delayed ovarian development. Conversely, heightened reproductive activity often suppresses functions. This trade-off has profound ecological evolutionary consequences, shaping insects’ survival, adaptation, population dynamics. The intricate interplay immunity insects is regulated by neuroendocrine endocrine systems, orchestrate resource distribution alongside other biological Key hormones, such as juvenile hormone ecdysteroids, serve central regulators, influencing responses activities. Additionally, macromolecules like vitellogenin lipophorin, primarily known for their functions yolk protein precursors lipid carriers, play crucial roles pathogen recognition transgenerational priming. Advancements molecular omics tools have unveiled complexity these regulatory mechanisms, providing new insights into how dynamically allocate resources to optimize fitness. delicate balance underscores critical strategies integration physiological systems across species. review synthesizes from life history theory, oogenesis, immunity, offering perspectives on trade-offs output investment.

Language: Английский

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Seminal fluid effects on uterine receptivity to embryo implantation: transcriptomic strategies to define molecular mechanisms

Reproduction Fertility and Development, Journal Year: 2025, Volume and Issue: 37(6)

Published: March 17, 2025

Embryo implantation requires both a developmentally competent embryo and receptive uterus. Impaired uterine receptivity is common constraint on success reproductive outcome. Ovarian steroid hormones oestrogen progesterone play central role in establishing receptivity, but other factors also contribute. One additional regulating factor male partner seminal fluid. However, the full physiological impacts of fluid specific molecular pathways involved are not yet completely defined. New advances RNA-sequencing technologies provide powerful means to examine how tissues cells respond contact. Findings utilising sequencing technology strong cellular evidence humans mice that contact around time ovulation drives immune vascular changes with potential affect endometrial peri-implantation phase. This approach has led discovery novel mediators regulatory subsequently shown facilitate genetic mouse models, enabling functional validation. Here, we summarise from recent microarray findings can directly indirectly impact transcriptional state tissue during window humans. Progress elucidating female tract response will improve understanding effects knowledge gained have practical applications for achieving healthy pregnancy offspring outcomes.

Language: Английский

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Exploring the Immunological Aspects and Treatments of Recurrent Pregnancy Loss and Recurrent Implantation Failure

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(3), P. 1295 - 1295

Published: Feb. 3, 2025

Recurrent pregnancy loss (RPL) is defined as the occurrence of two or more consecutive losses before 24 weeks gestation. It affects 3-5% women who are attempting to conceive. RPL can stem from a variety causes and frequently associated with psychological distress diminished quality life. By contrast, recurrent implantation failure (RIF) refers inability achieve successful after three high-quality embryo transfers at least instances egg donation. RIF shares several causative factors RPL. The immunological underpinnings these conditions involve alterations in uterine NK cells, reductions M2 macrophages myeloid-derived suppressor an increased Th1/Th2 ratio, decreased Treg/Th17 presence shared ≥3 HLA alleles between partners, autoimmune disorders. Various therapeutic approaches have been employed address concerns, achieving varying degrees success, although some therapies remain contentious within medical community. This review intends explore implicated analyze treatments for conditions, which may include steroids, intravenous immunoglobulins, calcineurin inhibitors, anti-TNF antibodies, intralipid infusions, granulocyte colony-stimulating factor, lymphocyte immunotherapy.

Language: Английский

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Revolutionized attitude toward recurrent pregnancy loss and recurrent implantation failure based on precision regenerative medicine

Heliyon, Journal Year: 2024, Volume and Issue: 10(20), P. e39584 - e39584

Published: Oct. 1, 2024

Language: Английский

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Wiederholter Spontanabort: Genetisch determinierte Risikofaktoren

Deutsches Ärzteblatt, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 6, 2024

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