Abstract：
Infertility affects 15 % of couples in the US, and many turn to assisted reproductive technologies, including in vitro fertilization and subsequent frozen embryo transfer (FET) to become pregnant. This study aimed to perform a broad assessment of the maternal immune system to determine if there are systemic differences on the day of FET in cycles that result in a live birth compared to those that do not. Women undergoing FET of euploid embryos were recruited and blood was collected on the day of FET as well as at early timepoints in pregnancy. Sixty immune and angiogenic proteins were measured in plasma, and gene expression of 92 immune-response related genes were evaluated in peripheral blood mononuclear cells (PBMCs). We found plasma concentrations of interleukin-13 (IL-13) and macrophage derived chemokine (MDC) were significantly lower on the day of FET in cycles that resulted in a live birth. We also found genes encoding C-C chemokine receptor type 5 (CCR5), CD8 subunit alpha (CD8A) and SMAD family member 3 (SMAD3) were upregulated in PBMCs on the day of FET in cycles that resulted in live birth. Measurements of immune mediators from maternal blood could serve as prognostic markers during FET to guide clinical decision making and further our understanding of implantation failure.
摘要：
在美国有15%的夫妇受到不孕症的影响，许多人转向辅助生殖技术，包括体外受精和随后的冷冻胚胎移植（FET）怀孕。这项研究旨在对母体免疫系统进行广泛评估，以确定在FET周期当天是否存在导致活产的系统性差异。招募接受整倍体胚胎FET的妇女，并在FET当天以及怀孕早期时间点收集血液。在血浆中测量了60种免疫和血管生成蛋白，在外周血单个核细胞（PBMC）中评估了92个免疫反应相关基因的基因表达。我们发现，在导致活产的周期中，在FET当天，白介素13（IL-13）和巨噬细胞衍生的趋化因子（MDC）的血浆浓度显着降低。我们还发现了编码C-C趋化因子受体5型（CCR5）的基因，CD8亚基α（CD8A）和SMAD家族成员3（SMAD3）在FET当天的PBMC中上调，导致活产。来自母体血液的免疫介质的测量可以作为FET期间的预后标志物，以指导临床决策并进一步了解我们对植入失败的理解。
