Immunotherapy in patients with recurrent implantation failure

Objective: to evaluate the effect of personalized immunotherapy on the frequency of pregnancy and gestation in women with recurrent implantation failure.

Materials and methods: the clinical immunogram before and aſter courses of personalized immunotherapy in 65 women with a history of recurrent implantation failure during the period of preparation for treatment under the ART program (24 cryoprotocols in the natural cycle, 41 cryoprotocols with hormone replacement therapy without pituitary blockade): CD3+, CD3+CD4+, CD3+CD8+, CD3+CD20+, CD16+ in direct reaction of surface immunofluorescence using monoclonal antibodies; concentration of serum Ig G, A, M by ELISA; total circulating immune complexes; Nitroblue tetrazolium (NBT) dye reduction test; phagocytic activity of neutrophils.

Results: the immune status of 100% of patients with secondary infertility and 36.4% of women with primary infertility is characterized by secondary T-immunodeficiency and significant activation of both B-lymphocytes and cellular factors of nonspecific body protection — peripheral NK cells (CD16+) and neutrophils. Repeated courses of personalized immunotherapy in women with a history of recurrent implantation failure led to normalization of altered immune parameters and showed their effectiveness in 67.7% of patients who gave birth to live children.

Conclusion: one of the leading reasons for habitual ineffective implantation in the presence of euploid embryos of good quality is general and local (endometrial) immunological imbalance. A personalized approach to the selection of immunotherapy for each patient optimizes the frequency of implantation, the onset and outcome of pregnancy.