ArticleFertility research and practice2018
ART implantation failure and miscarriage in patients with elevated intracellular cytokine ratios: response to immune support therapy.
Article in Fertility research and practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Intralipid therapy and adverse reproductive outcome: is there any evidence?Reproduction & fertility · 2021Pooled it
- Immunological Role of Intrauterine Human Chorionic Gonadotropin in Infertile Women Undergoing ICSI.Journal of obstetrics and gynaecology of India · 2026Article
- Phenotype- and phase-directed immune interpretation in recurrent implantation failure and pregnancy loss: an integrative framework.Frontiers in reproductive health · 2026Review
- Immunotherapy and IVF Outcomes in Unexplained Recurrent Pregnancy Loss: A Systematic Review with Implications for Personalized Reproductive Medicine.Journal of personalized medicine · 2025Review
- Intrauterine application of Budesonide-hyaluronic acid gel in patients with recurrent implantation failure and total loss of junctional zone differentiation on magnetic resonance imaging.Facts, views & vision in ObGyn · 2025Article
- Altered Expressions ofJournal of clinical medicine · 2024Article
- Should the Treatment of Patients with Repeated Embryo Implantation Failure Be Adapted as a Function of the Endometrial Cytokine Profile? A Single-Center Experience.Biomedicines · 2023Article
- Immune Tolerance of Embryo Implantation and Pregnancy: The Role of Human Decidual Stromal Cell- and Embryonic-Derived Extracellular Vesicles.International journal of molecular sciences · 2022Review
- The Role of Interleukins in Recurrent Implantation Failure: A Comprehensive Review of the Literature.International journal of molecular sciences · 2022Review
- Understanding the cross-talk between mediators of infertility and COVID-19.Reproductive biology · 2021Review
- Endometrial lymphocyte concentrations in adverse reproductive outcome populations.Journal of assisted reproduction and genetics · 2019Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe origins of adverse reproductive outcome can be multifactorial, but the contribution of the maternal immune system is considered debatable. Elevated intracellular cytokine ratios have been proposed, although not universally supported, as a marker for immunological dysfunction in implantation and early pregnancy. Poor patient selection or inadequate treatment or testing may be confounding factors. Specific immunomodulation, in carefully selected sub-populations of ART patients with poor reproductive history, despite transfer of good quality blastocysts, may potentially improve clinical outcomes.
methodsIntracellular cytokine ratios (CKR) were prospectively assessed in 337 patients presenting with a history of implantation failure and/or pregnancy loss, prior to further treatment, and were found to be elevated in 150 (44.5%). Of this group, 134 agreed to initiate a standardised immunotherapy regime (nutraceuticals, prednisolone & intralipids) to evaluate the efficacy of this proposed therapy. Of the intervention population, a small cohort (
resultsBaseline assessment in the intervention population (
conclusionsFollowing immunomodulation, significant improvements in both implantation rate and miscarriage rate were seen in this poor prognosis population. This suggests a possible role for both detailed immuno-evaluation of patients with poor reproductive history with good embryo quality, and application of personalised immunotherapy regimes alongside ART in selected cases. Future randomised controlled trials are needed to definitively evaluate this potentially promising therapeutic approach.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.