P–390 The intrauterus administration of peripheral blood mononuclear cells increase the pregnancy rates for the patients with advanced maternal age after single euploid embryo transfer

Abstract

Study question Does the intrauterine administration of peripheral blood mononuclear cells (PBMCs) effect the outcome of IVF for patients with advanced maternal age when the euploid embryos after PGT-A are transferred? Summary answer The implantation rates were significantly higher after the intrauterine application of PBMCs in patients with advanced maternal age (AMA) before transfer of the euploid embryo. What is known already The aneuploidy rates of blastocysts in IVF is in range 45–70% depending on different factors. Besides that, the endometrium plays an important role in achieving optimal outcomes of assisted reproductive technologies. It has been proposed that intrauterine administration of peripheral blood mononuclear cells modulates maternal immune response to favor implantation. Study design, size, duration The effect of the intrauterine application of PBMCs to improve the implantation rates in the group of patients with advanced maternal age was studied. Two group of patients (PBMCs-group and non-PBMCs-group_ were formed. Single euploid embryo was transferred for each patient. Participants/materials, setting, methods: The ploidy status of 373 blastocysts from 82 AMA-patients was analyzed by the method of next generation sequencing (NGS). PBMCs were applied for 39 women with the mean age 39.2±3.2 y.o. before embryo transfer (Group 1). For 43 patients with the mean age 38.2±2.1 y.o. single euploid embryo transfers were performed without PBMCs administration (Group 2). Chi-squared test was used for data analysis. The study’s protocol was approved by the Center’s IRB. Main results and the role of chance Totally the rate of euploid embryos was 27.1% (101 blastocysts). In the mentioned study 55.0% of examined blastocysts were aneuploid (205 embryos) and 17.9% of blastocysts were detected as mosaic (67 embryos). Single euploid embryo was transferred in each case in the patients of both experimental groups. The implantation rate was significantly higher in Group 1 with PBMCs application comparing with non-PBMCs experimental Group 2 (38.5% (15 pregnancies) vs. 23.3% (10 pregnancies), df = 1, χ2 = 5.487, χ2critical = 3.841, P = 0.020). Limitations, reasons for caution The embryo biopsy was performed only for blastocyst with top-quality morphology. Wider implications of the findings: The implantation rates were significantly higher when the intrauterine application of PBMCs in patients with advanced maternal age before the transfer of the euploid embryo (P = 0.020). The randomized studies to improve our knowledge in immunogenic therapy in reproductive medicine should be performed. Trial registration number -