The Effect of Intrauterine Autologous Peripheral Blood Mononuclear Cells (PBMCs) Administration in Modulating the Immunologic Profile Aberrations in Repeated Implantation Failure (RIF) Women.

Purpose: Considering the immune-related etiology of RIF, administration of an immunomodulatory approach such as autologous PBMCs seems to be helpful in modifying the dysregulated immune responses. Methods: 100 RIF women were divided into the PBMC receiving and the control group. Blood sampling was conducted 48 h before and 2 weeks after PBMC administration. The frequency of Th17, Treg, and NK cells, the expression level of related transcription factors and miRNAs, and the concentration of inflammatory and anti-inflammatory cytokines were evaluated pre- and post-treatment. Pregnancy outcome including pregnancy, live birth, and miscarriage rates were also evaluated. Results: PBMC therapy significantly elevated the frequency of Th17 and NK cells (p = 0.0035 and 0.0013, respectively) and the expression of RORγt (p < 0.0001), in comparison with pre-treatment, while the frequency of Treg cells (p = 0.0063) and the expression of FoxP3 and PTEN were decreased post treatment. The serum concentration of IL-1β, IL-17, and TNF-α was increased, while IL-10 and TGF-β were reduced post-treatment when compared to pre-treatment. Pregnancy and live birth rates were significantly higher in the PBMC-treated group in comparison with routine treatment. Conclusion: Intrauterine administration of autologous PBMCs may be helpful in treating RIF patients, especially those with decreased inflammatory cells and mediators in the implantation process.