In this innovative research conducted by Alba Alarcón, Embryologist at the IVF-Life Madrid laboratories, the analysis focused on the blood of a group of patients who experienced recurrent implantation failures (RIF) of unexplained cause, aiming to study their cellular immunity.
The driving force behind the study is to determine whether any imbalance in this context could be responsible for the reproductive failure.
Recurrent implantation failure is classically defined as the failure to achieve pregnancy in patients under 40 years who have had at least 4 good quality embryos transferred at the cell stage across at least 3 transfers. In current clinical practice, with specialists better understanding the factors involved and more efficient approaches, techniques, and technologies available for management, the diagnosis of RIF usually occurs before meeting the formal definition criteria.
RIF cases are often caused by uterine, embryonic, immunological factors or coagulation disorders, among others, yet a small percentage of patients (less than 5%) have reproductive failure deemed of unexplained origin. This is the group Alba Alarcón has focused on to observe cellular immunity and investigate whether any underlying alteration could improve treatment prognosis.
The study sample included 12 non-pregnant women with a history of unexplained RIF, and two control groups: the first with 40 fertile women who delivered at least one live newborn, and the second with 60 patients with no prior pregnancies. Variables such as age, number of failed cycles, type of infertility (primary or secondary), and prior immunological abnormalities studied were included.
After establishing the groups and collecting valuable data, analysis was performed on different lymphocyte and monocyte subpopulations in the patients' peripheral blood. Lymphocytes and monocytes regulate the immune response of an individual and were studied to find any association with unexplained RIF.
Analyzed lymphocyte subpopulations included T cells (involved in cellular immunity), B cells (antibody producers), percentage of natural killer (NK) cells associated with innate immune response, and natural killer T (NKT) cells, which show characteristics of both T lymphocytes and natural killer cells.
The results showed that compared to the two control groups, the RIF patient group had higher levels of NKT cells, cytotoxic T lymphocytes, and B cells, with correspondingly lower percentages of T lymphocytes. When considering factors such as age, infertility type, and number of implantation failures, patients under 35 years had significantly lower percentages of T lymphocytes than older patients.
Ultimately, the immunophenotypic profile of women with RIF in this study appears to show alterations in lymphocyte subpopulations, possibly playing a pathogenic role. Additionally, age may influence the cellular immune system in these patients.
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