{"title":"Tacrolimus treatment in women with repeated implantation failures.","authors":"Koji Nakagawa, Rikikazu Sugiyama","doi":"10.1002/rmb2.12558","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus is an immunosuppressive drug that works as a calcineurin inhibitor to improve the reproductive outcomes for women who have experienced multiple implantation failures (RIF) and show elevated type 1 helper T (Th1)/Th2 cell ratios.</p><p><strong>Methods: </strong>In the first part of this review, we indicate how we re-evaluated the cut-off index for selecting the participants in a tacrolimus regimen via transferred euploid blastocysts. In the second part, we cite cases where tacrolimus has improved the live birth rate for women who have experienced recurrent pregnancy losses (PRL) and we introduce the utility of tacrolimus treatment to prevent obstetrical complications.</p><p><strong>Main findings: </strong>After reconsideration of the cut-off index (Th1/Th2 ≥ 11.8), however, the pregnancy rates of women with tacrolimus were significantly higher than those of women without tacrolimus. The PRL women treated with tacrolimus showed significantly lower rates of biochemical pregnancy, but higher live-birth rates compared with women who were not treated with tacrolimus. Moreover, prior severe obstetrical complications could be controlled via the administration of tacrolimus during pregnancy.</p><p><strong>Conclusion: </strong>Tacrolimus has become indispensable in the field of solid-organ transplantation, and in the near future, it should become an essential agent in the reproductive field, as well.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12558"},"PeriodicalIF":2.7000,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775185/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive Medicine and Biology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/rmb2.12558","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Tacrolimus is an immunosuppressive drug that works as a calcineurin inhibitor to improve the reproductive outcomes for women who have experienced multiple implantation failures (RIF) and show elevated type 1 helper T (Th1)/Th2 cell ratios.
Methods: In the first part of this review, we indicate how we re-evaluated the cut-off index for selecting the participants in a tacrolimus regimen via transferred euploid blastocysts. In the second part, we cite cases where tacrolimus has improved the live birth rate for women who have experienced recurrent pregnancy losses (PRL) and we introduce the utility of tacrolimus treatment to prevent obstetrical complications.
Main findings: After reconsideration of the cut-off index (Th1/Th2 ≥ 11.8), however, the pregnancy rates of women with tacrolimus were significantly higher than those of women without tacrolimus. The PRL women treated with tacrolimus showed significantly lower rates of biochemical pregnancy, but higher live-birth rates compared with women who were not treated with tacrolimus. Moreover, prior severe obstetrical complications could be controlled via the administration of tacrolimus during pregnancy.
Conclusion: Tacrolimus has become indispensable in the field of solid-organ transplantation, and in the near future, it should become an essential agent in the reproductive field, as well.
背景:他克莫司是一种免疫抑制剂,作为一种钙神经蛋白抑制剂,可改善经历过多次植入失败(RIF)并显示出1型辅助T细胞(Th1)/Th2细胞比率升高的妇女的生殖结局:在本综述的第一部分,我们介绍了如何重新评估通过移植优倍囊胚选择他克莫司方案参与者的临界指标。在第二部分中,我们列举了他克莫司提高反复妊娠损失(PRL)妇女活产率的案例,并介绍了他克莫司治疗在预防产科并发症方面的效用:主要研究结果:在重新考虑截断指数(Th1/Th2 ≥ 11.8)后,使用他克莫司的妇女的妊娠率明显高于未使用他克莫司的妇女。与未接受他克莫司治疗的妇女相比,接受他克莫司治疗的 PRL 妇女的生化妊娠率明显较低,但活产率较高。此外,通过在孕期使用他克莫司,可以控制之前出现的严重产科并发症:结论:他克莫司已成为实体器官移植领域不可或缺的药物,在不久的将来,它也会成为生殖领域不可或缺的药物。
期刊介绍:
Reproductive Medicine and Biology (RMB) is the official English journal of the Japan Society for Reproductive Medicine, the Japan Society of Fertilization and Implantation, the Japan Society of Andrology, and publishes original research articles that report new findings or concepts in all aspects of reproductive phenomena in all kinds of mammals. Papers in any of the following fields will be considered: andrology, endocrinology, oncology, immunology, genetics, function of gonads and genital tracts, erectile dysfunction, gametogenesis, function of accessory sex organs, fertilization, embryogenesis, embryo manipulation, pregnancy, implantation, ontogenesis, infectious disease, contraception, etc.