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CLINICAL RESEARCH
Value of autoimmune screening and immunomodulatory treatment to improve subsequent pregnancy outcomes in patients undergoing preimplantation genetic testing
1
Department of Reproductive Medicine and Genetics Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
2
Hubei Clinical Research Center for Reproductive Medicine, Shiyan, China
3
Shiyan Key Laboratory of Reproduction and Genetics (Renmin Hospital, Hubei University of Medicine), Shiyan, China
4
Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, China
5
Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Submission date: 2026-01-11
Final revision date: 2026-03-22
Acceptance date: 2026-05-04
Online publication date: 2026-08-18
Corresponding author
Wei Tu
Department of Rheumatology and Immunology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan, China, 430030 Phone: +86-18238638530
Department of Rheumatology and Immunology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan, China, 430030 Phone: +86-18238638530
Shulin Yang
Department of Reproductive Medicine and Genetics Center Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan, China, 430030 Phone: +86-15927001408
Department of Reproductive Medicine and Genetics Center Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan, China, 430030 Phone: +86-15927001408
KEYWORDS
preimplantation genetic testingeuploid blastocystautoimmune screeningtargeted immunomodulationempirical therapy
TOPICS
ABSTRACT
Introduction:
We aimed to evaluate the clinical utility of autoimmune screening and the effectiveness of immunomodulatory treatment in preimplantation genetic testing (PGT) patients.
Material and methods:
In this retrospective cohort study, 151 PGT patients who experienced a failed first frozen embryo transfer (FET) were divided into two groups. Patients underwent immune marker screening before their second FET. Among them, 42 were classified into the immune-positive group and received targeted interventions, while 109 were categorized into the immune-negative group, which was further divided into an empirical medication subgroup (n = 43) and a no-intervention subgroup (n = 66). Baseline characteristics and pregnancy outcomes were analyzed using statistical methods, including univariate and multivariate logistic regression analyses.
Results:
We found that among PGT patients with first transfer failure, 28% (42/151) showed abnormal immune markers. Targeted therapy in immune-positive patients was associated with significantly improved clinical pregnancy rates compared to their first unscreened cycle (64.29% vs. 33.33%, p = 0.005), while reducing the miscarriage rate. In contrast, empirical immunomodulation in immune-negative patients did not provide any additional benefit in terms of live birth rate (39.53% vs. 43.94%, p = 0.649). Multivariate analysis confirmed that embryo quality was an independent positive predictor of both hCG positivity (p = 0.034) and clinical pregnancy (p = 0.022), whereas maternal age showed an inverse association with the likelihood of success (p < 0.05).
Conclusions:
Immune abnormalities are relatively prevalent in the PGT population. Targeted immunomodulatory interventions in immune-positive patients were associated with improved pregnancy outcomes. We recommend that these patients should undergo immune screening and targeted interventions before embryo transfer. However, empirical therapy in immune-negative individuals is unjustified.
We aimed to evaluate the clinical utility of autoimmune screening and the effectiveness of immunomodulatory treatment in preimplantation genetic testing (PGT) patients.
Material and methods:
In this retrospective cohort study, 151 PGT patients who experienced a failed first frozen embryo transfer (FET) were divided into two groups. Patients underwent immune marker screening before their second FET. Among them, 42 were classified into the immune-positive group and received targeted interventions, while 109 were categorized into the immune-negative group, which was further divided into an empirical medication subgroup (n = 43) and a no-intervention subgroup (n = 66). Baseline characteristics and pregnancy outcomes were analyzed using statistical methods, including univariate and multivariate logistic regression analyses.
Results:
We found that among PGT patients with first transfer failure, 28% (42/151) showed abnormal immune markers. Targeted therapy in immune-positive patients was associated with significantly improved clinical pregnancy rates compared to their first unscreened cycle (64.29% vs. 33.33%, p = 0.005), while reducing the miscarriage rate. In contrast, empirical immunomodulation in immune-negative patients did not provide any additional benefit in terms of live birth rate (39.53% vs. 43.94%, p = 0.649). Multivariate analysis confirmed that embryo quality was an independent positive predictor of both hCG positivity (p = 0.034) and clinical pregnancy (p = 0.022), whereas maternal age showed an inverse association with the likelihood of success (p < 0.05).
Conclusions:
Immune abnormalities are relatively prevalent in the PGT population. Targeted immunomodulatory interventions in immune-positive patients were associated with improved pregnancy outcomes. We recommend that these patients should undergo immune screening and targeted interventions before embryo transfer. However, empirical therapy in immune-negative individuals is unjustified.
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| eISSN: | 1896-9151 |
| ISSN: | 1734-1922 |
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