Endometrial Immune Profiling: A Method to Design Personalized Care in Assisted Reproductive Medicine

Area of Science:

• Reproductive immunology
• Personalized medicine in infertility

Background:

• Reproductive failures may stem from uterine immune dysregulation.
• Endometrial immune profiling offers a potential diagnostic and therapeutic avenue.

Purpose of the Study:

• To evaluate the efficacy of endometrial immune profiling for personalized infertility care.
• To determine if targeted interventions based on immune status improve pregnancy rates.

Main Methods:

• Prospective cohort study involving 1738 infertile patients undergoing endometrial immune profiling via biopsy.
• Classification of immune profiles: balanced, under-activation, over-activation, or mixed.
• Personalized treatment plans were suggested for dysregulation; outcomes of subsequent embryo transfers were recorded.

Main Results:

• 16.5% had balanced profiles, while 83.5% showed immune dysregulation (28% under-activation, 45% over-activation, 10.5% mixed).
• Patients with repeated implantation failures (RIF) or recurrent miscarriages (RM) had significantly higher pregnancy rates (37.7% and 56%) when treated based on immune profiling compared to those without (26.9% and 24%).
• Sensitivity testing for immunotherapy in cases of immune over-activation correlated with higher pregnancy rates (51% vs. 39.9%).

Conclusions:

• Local endometrial immunity is a significant factor influencing pregnancy prognosis.
• Targeted medical care for endometrial immune dysregulation significantly improves pregnancy rates in RIF and RM patients.
• Endometrial immune profiling enables personalized strategies to enhance fertility success.