Using endometrial immune profiling in young IVF patients: implantation rates improved for morphologically sub-optimal embryos

Introduction A balanced endometrial immune profile is considered to be the ideal environment for a successful implantation, as opposed to endometrial immune dysregulation. However, the embryo quality may be the pivotal ‘immune’ factor compared to the uterine immune environment. Study method After providing informed consent, young infertile patients involved in ART underwent an analysis of their endometrial immune profile before their embryo transfer (ET). Each ET was classified as a Top transfer if the used embryos were of Top morphology; all other transfers were classified as non-Top. The live birth rate (LBR) after ET was compared between patients with a balanced endometrial immune profile and patients with a dysregulated endometrial immune profile, with no intervention to regulate the endometrial environment (conventional care). Results Overall, the LBR did not differ significantly between patients with balanced and dysregulated endometrial profile receiving conventional care (39.5% vs 29.7%; OR: 1.55 [0.66–2.72]). However, among patients with a non-Top transfer, the LBR was higher in the balanced group (38.4% vs 21.2%; OR: 2.11 [1.02–4.37]). In contrast, no difference was observed in the case of a Top transfer (46.3% vs 45.8%; OR: 0.99 [0.38–2,55]). Conclusion These preliminary results suggest that a balanced endometrial immune environment may favour the implantation in patients using morphologically suboptimal embryos. In contrast, an endometrial immune dysregulation negatively impacts the implantation of morphologically suboptimal embryos. Trial registration NCT02262117 Trial registration date October, 7th, 2014 Date of the first patient’s enrolment October, 30th, 2015