Abstract
Problem: We evaluated the clinical efficacy of immunosuppressive treatment with tacrolimus for repeated implantation failure (RIF) patients who have elevated in T helper (Th1)/Th2 cytokine producing cell ratios. Method of study: This was a prospective cohort study of treatment for RIF patients (n = 42) with elevated peripheral blood Th1 (CD4+/IFN-γ+)/Th2 (CD4+/IL-4+) cell ratios at the Sugiyama clinic between November 2011 and October 2013. Twenty-five patients were treated with tacrolimus (treatment group) and 17 received no treatment (control group). Treatment group received tacrolimus 2 days before embryo transfer and continued until the day of the pregnancy test, for a total of 16 days. The daily dose of tacrolimus (1-3 mg) was determined based on the degree of the Th1/Th2 cell ratio. Results: The clinical pregnancy rate of the treatment group was 64.0%, which was significantly higher than that of the control group (0%) (P < 0.0001). In the treatment group, the miscarriage rate was 6.3%, the live birthrate was 60.0% (P < 0.0001). There was no significant side-effect from tacrolimus in treatment group. No one developed obstetrical complications during pregnancy. Conclusion: An immunosuppressive treatment using tacrolimus improved pregnancy outcome of repeated implantation failure patients with elevated Th1/Th2 ratios.
| Original language | English |
|---|---|
| Pages (from-to) | 353-361 |
| Number of pages | 9 |
| Journal | American Journal of Reproductive Immunology |
| Volume | 73 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2015 Apr 1 |
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Keywords
- IVF
- Repeated implantation failure
- Tacrolimus
- Th1/Th2 ratios
ASJC Scopus subject areas
- Immunology
- Immunology and Allergy
- Obstetrics and Gynaecology
- Reproductive Medicine
Cite this
Immunosuppression with tacrolimus improved reproductive outcome of women with repeated implantation failure and elevated peripheral blood th1/th2 cell ratios. / Nakagawa, Koji; Kwak-Kim, Joanne; Ota, Kuniaki; Kuroda, Keiji; Hisano, Michi; Sugiyama, Rikikazu; Yamaguchi, Koushi.
In: American Journal of Reproductive Immunology, Vol. 73, No. 4, 01.04.2015, p. 353-361.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Immunosuppression with tacrolimus improved reproductive outcome of women with repeated implantation failure and elevated peripheral blood th1/th2 cell ratios
AU - Nakagawa, Koji
AU - Kwak-Kim, Joanne
AU - Ota, Kuniaki
AU - Kuroda, Keiji
AU - Hisano, Michi
AU - Sugiyama, Rikikazu
AU - Yamaguchi, Koushi
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Problem: We evaluated the clinical efficacy of immunosuppressive treatment with tacrolimus for repeated implantation failure (RIF) patients who have elevated in T helper (Th1)/Th2 cytokine producing cell ratios. Method of study: This was a prospective cohort study of treatment for RIF patients (n = 42) with elevated peripheral blood Th1 (CD4+/IFN-γ+)/Th2 (CD4+/IL-4+) cell ratios at the Sugiyama clinic between November 2011 and October 2013. Twenty-five patients were treated with tacrolimus (treatment group) and 17 received no treatment (control group). Treatment group received tacrolimus 2 days before embryo transfer and continued until the day of the pregnancy test, for a total of 16 days. The daily dose of tacrolimus (1-3 mg) was determined based on the degree of the Th1/Th2 cell ratio. Results: The clinical pregnancy rate of the treatment group was 64.0%, which was significantly higher than that of the control group (0%) (P < 0.0001). In the treatment group, the miscarriage rate was 6.3%, the live birthrate was 60.0% (P < 0.0001). There was no significant side-effect from tacrolimus in treatment group. No one developed obstetrical complications during pregnancy. Conclusion: An immunosuppressive treatment using tacrolimus improved pregnancy outcome of repeated implantation failure patients with elevated Th1/Th2 ratios.
AB - Problem: We evaluated the clinical efficacy of immunosuppressive treatment with tacrolimus for repeated implantation failure (RIF) patients who have elevated in T helper (Th1)/Th2 cytokine producing cell ratios. Method of study: This was a prospective cohort study of treatment for RIF patients (n = 42) with elevated peripheral blood Th1 (CD4+/IFN-γ+)/Th2 (CD4+/IL-4+) cell ratios at the Sugiyama clinic between November 2011 and October 2013. Twenty-five patients were treated with tacrolimus (treatment group) and 17 received no treatment (control group). Treatment group received tacrolimus 2 days before embryo transfer and continued until the day of the pregnancy test, for a total of 16 days. The daily dose of tacrolimus (1-3 mg) was determined based on the degree of the Th1/Th2 cell ratio. Results: The clinical pregnancy rate of the treatment group was 64.0%, which was significantly higher than that of the control group (0%) (P < 0.0001). In the treatment group, the miscarriage rate was 6.3%, the live birthrate was 60.0% (P < 0.0001). There was no significant side-effect from tacrolimus in treatment group. No one developed obstetrical complications during pregnancy. Conclusion: An immunosuppressive treatment using tacrolimus improved pregnancy outcome of repeated implantation failure patients with elevated Th1/Th2 ratios.
KW - IVF
KW - Repeated implantation failure
KW - Tacrolimus
KW - Th1/Th2 ratios
UR - http://www.scopus.com/inward/record.url?scp=84924408927&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924408927&partnerID=8YFLogxK
U2 - 10.1111/aji.12338
DO - 10.1111/aji.12338
M3 - Article
AN - SCOPUS:84924408927
VL - 73
SP - 353
EP - 361
JO - American Journal of Reproductive Immunology and Microbiology
JF - American Journal of Reproductive Immunology and Microbiology
SN - 8755-8920
IS - 4
ER -