Favorable immune phenotype predicts successful implantation and pregnancy

Abstract

Immune markers that may predict IVF failure and successful implantation and pregnancy were studied. Favorable immune parameters were selected based on 90% of data of women who got pregnant and had uneventful pregnancy course and outcome in present IVF cycle. Immune phenotype and NK cell activity of peripheral blood of 123 women with multiple IVF failure were studied by flow cytometry. Some parameters that were out of favorable borders (elevated expression of CD56, CD158a in T lymphocytes, decreased levels of CD4 T lymphocytes, up-regulated expression of HLA DR in CD8+ T cells and NK cells, elevated number of NK cells and increased NK cytotoxicity, increased and decreased expression of CD158a and CD8 in NK cells) were considered to be immune deviations (ID) potentially predictive for IVF failure. In women with 0–1 ID implantation rate (IR) was 50.9% (27/53), with two ID – 42.8% (12/28), with three and more ID – 21.4% (9/42). IR in group with three ID was lower than in group with 0–1 ID (p<0.01, OR=3.8, CI: 1.52–9.48) and in group with two ID (p<0.05). Live birth rate (LBR) in women with 0–1 ID was 33.9%, with two ID – 28.5%, with three and more ID – 9.5%. LBR in group with three ID was lower than in group with 0–1 ID (p<0.01, OR=4.8, CI: 1.52–15.8) and in group with two ID (p<0.05). The absence or single ID seems to be more favorable for successful IVF program. Combination of ID may predict implantation failure to a greater degree than isolated ID. Multiple immune deviations form unfavorable “immune phenotype” for implantation and pregnancy development.