Infertility affects about one in seven couples in France. Beyond the medical and personal challenges, it has major societal implications. In vitro fertilization (IVF) offers hope to these couples, but success rates remain modest (about 30% per embryo transfer). The failure of embryo implantation is multifactorial. Among the factors involved, immune status at the time of embryo transfer plays a central role. Embryo transfer induces an acute pro-inflammatory immune response, and inadequate regulation of this response could compromise implantation.
We have previously identified a promising immune biomarker: TGF-β (Transforming Growth Factor Beta). In a prospective cohort of 255 patients undergoing frozen embryo transfer, we demonstrated that low circulating levels of TGF-β following nonspecific stimulation of immune cells on the day of embryo transfer were associated with a significant increase in the likelihood of implantation and live birth.
These results now require independent validation in a new cohort to establish their robustness and explore potential clinical applications. We hypothesize that measuring TGF-β concentration following stimulation can predict the success of embryo implantation.
Adult women,
Undergoing IVF treatment at the Nice University Hospital for frozen embryo transfer following a semi-natural or stimulated cycle,
Enrolled in the social security system,
No objection to participating in the study.
Any contraindication to frozen embryo transfer
Patients receiving donated gametes during this embryo transfer attempt
Current infectious disease
Patients protected by law who are under guardianship or conservatorship, or who are ineligible to participate in a clinical trial pursuant to Article L. 1121-16 of the French Public Health Code;
Infertile woman
Cohort
Prospective
Not listed
Low circulating levels of TGF-β
To conduct an exploratory validation, in an independent cohort, of the association between low circulating levels of TGF-β-following nonspecific cellular stimulation at the time of frozen embryo transfer (after a semi-natural or stimulated cycle)-and an increased likelihood of embryo implantation. Embryo implantation will be confirmed by the visualization of an intrauterine gestational sac on an ultrasound performed during the first trimester following embryo transfer.
Association between TGF-β and the number of live births.
Confirm the association between low levels of stimulated TGF-β and the number of live births by noting the final outcome of the pregnancy: live birth or stillbirth.
Circulating lymphocyte populations
Study circulating lymphocyte populations and their functional profile (intracellular cytokines) by flow cytometry, measuring cytokine levels (IL-1R, IL-2R, IL-6, IL-8, IL-10, IL-18, IFN-γ, TNF-α, IL-17A, IL-4, TGF-β, IL-12p70, IL-5 (in pg/ml)) found in cell supernatants following nonspecific stimulation (anti-CD3 agonist + TLR7/8 ligand), lymphocyte phenotyping (Th1, Th2, Treg, NK), and intracellular cytokine measurement by flow cytometry.
Impact of exposure to air pollution
Assess the impact of exposure to air pollution on immune status and the success of embryo transfer by measuring average exposure to PM10, PM2.5, NO2, and O3 (in µg/m³) during the 6 months preceding embryo transfer.
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