Study on the Efficacy of Intrauterine Perfusion with Autologous PBMCs Cocultured with Human Chorionic Gonadotropin in Patients with Failed Embryo Implantation

ZHANG Huina; WANG Tao; XU Ling; WANG Fangfang; ZHANG Hongjuan; WANG Li; LIU Zixia

doi:10.13730/j.issn.2097-2148.2024.10.005

Abstract：Objective To analyze the clinical pregnancy outcome of intrauterine infusion with autologous peripheral blood mononuclear cells(PBMCs)cocultured with human chorionic gonadotropin(HCG)in patients with embryo implan-tation failure,and explore the clinical significance and mechanism in the treatment of embryo implantation failure.Methods A total of 120 patients with embryo implantation failure who received frozen-thawed embryo transfer(FET)in the reproductive medicine center of author's hospital were randomly divided into experimental group and control group,with 60 patients in each group,the experimental group received intrauterine infusion of autologous PBMCs cocultured with HCG 3 days before FET,routine FET was performed in control group.The implantation rate,clinical pregnancy rate and abortion rate of the two groups were collected.The levels of macrophage inflammatory protein 1 alpha(MIP-1α),MIP-1β,interleukin 5(IL-5),IL-6,IL-8,IL-15,granulocyte macrophage colony-stimulating factor(GM-CSF),regulated upon activation normal T cell expressed and secreted(RANTES),basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF),interleukin 1 receptor antagonist(IL-1 Ra),monocyte chemotactic protein 1(MCP-1)and granulo-cyte colony stimulating factor(G-CSF)in the uterine cavity fluid were detected before and after infusion by Bio-plex suspension chip analysis system.Propensity score matc-hing method was used to match the experimental group with the control group with similar characteristics in all aspects,and the matched data were statistically analyzed.Results There was a significant difference in the number of embryo implantation failures between the experimental group and the control group before matching(P＜0.05),propensi-ty scores matched 90 patients,45 patients in the experimental group and 45 patients in the control group,the baseline da-ta were comparable after matching(P＞0.05).There was no difference in the embryo implantation rate,clinical pregnancy and abortion rate between the experimental group and the control group after matching(all P＞0.05);after uterine perfu-sion,the levels of MIP-1β,IL-6,IL-1Ra,IL-5,GM-CSF,RANTES,VEGF and IL-15 in uterine fluid were significantly higher than those before perfusion,and the levels of MCP-1 and G-CSF were significantly lower than those before perfu-sion(all P＜0.05),there was no significant difference in the levels of MIP-1α,IL-8 and bFGF before and after perfusion(all P＞0.05).Conclusion Intrauterine perfusion with PBMCs cocultured with HCG did not show an absolute advantage in improving clinical pregnancy outcomes in patients with failed embryo implantation,but it can change the expression of some endometrium receptivity related factors.