Immunoregulatory Therapy in Frozen Embryo Transfer Cycle Improved Reproductive Outcomes of Women with Elevated Peripheral Blood Th1/Th2 Ratios

Abstract Backgrounds: Little observational data exist describing prednisone+ hydroxychloroquine+cyclosporine (PDN+HCQ+CsA), prednisone+ hydroxychloroquine (PDN+HCQ), prednisone (PDN) therapy for improving IVF-ET outcomes in patients with elevated peripheral Th1/Th2 ratio.Methods: Retrospectively collected patients who was failed in IVF-ET and had elevated Th1/Th2 ratio between 1/2019 and 3/2020. Based on researches, elevated Th1/Th2 ratio was defined as equal to 10.3 or above. Patients were assigned into treatment group and control group based on whether received immunoregulatory treatment (PDN+HCQ+CsA/PDN+HCQ/PDN) during frozen transfer cycle. Results: Forty-one patients (PDN+HCQ+CsA/PDN+HCQ/PDN=21/9/11) in treated group and 30 patients in control group were enrolled in the study. No differences were found of baseline characteristics between treated group and untreated group. Rate of live birth was higher in treated group compared with untreated patients (41.5% vs. 16.7%, P=0.026). Rate of biochemical pregnancy (56.1% vs. 40%, P=0.18), implantation (36.5% vs. 23.9%, P=0.15), clinical pregnancy (51.2% vs. 30%, P=0.0743) were higher than control group but there were no statistical significances. Conclusions: Use of prednisone+ hydroxychloroquine+ cyclosporine or prednisone+ hydroxychloroquine, or prednisone during frozen embryo transfer cycle for patients with past implantation failure and elevated peripheral Th1/Th2 ratio improved live birth rate compared to those untreated.