Journal of Shandong University (Health Sciences) ›› 2026, Vol. 64 ›› Issue (7): 42-49.doi: 10.6040/j.issn.1671-7554.0.2025.0602

• Clinical Medicine • Previous Articles     Next Articles

Changes in endometrial microenvironment and its impact on pregnancy outcomes after frozen embryo transfer in patients with recurrent implantation failure

ZHAO Jianhua, FAN Yanling, FENG Chengwen   

  1. Department of Reproductive Genetics, Tangshan Maternal and Child Health Hospital, Tangshan 063014, Hebei, China
  • Online:2026-07-10 Published:2026-07-21

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Abstract: Objective To investigate the dynamic changes in the endometrial microenvironment before and after frozen embryo transfer(FET)in patients with recurrent implantation failure(RIF), analyze their impact on pregnancy outcomes. Methods This prospective study enrolled 80 patients with RIF(RIF group)and 80 patients undergoing their first FET without RIF(control group)from March 2022 to April 2024. Serum levelsfollicle-stimulating hormone(FSH)and anti-Müllerian hormone(AMH)were measured upon admission. Changes in endometrial microenvironment were evaluated by quantifying cytokines, including vascular endothelial growth factor(VEGF), interleukin-1β(IL-1β), transforming growth factor-β1(TGF-β1), and interferon-γ(IFN-γ), in uterine cavity fluid before and after embryo transfer. Pregnancy outcomes, including biochemical pregnancy, clinical pregnancy, miscarriage rate, and live birth rate, were compared between the two groups. Univariate and multivariate analyses were conducted to identify independent risk factors influencing clinical pregnancy in RIF patients. Results Prior to embryo transfer, levels of IL-1β, TGF-β1, and IFN-γ were significantly higher in the RIF group than in the control group(P<0.05). Post-transfer, VEGF and TGF-β1 levels in the RIF group were significantly lower than those in the control group(P<0.05), whereas IL-1β and IFN-γ levels were significantly elevated(P<0.05). The RIF group also exhibited significantly lower clinical pregnancy and live birth rates compared to the control group(P<0.05). Both univariate and multivariate regression analyses indicated that FSH, AMH, post-transplantation IL-1β, and IFN-γ were significant independent risk factors affecting clinical pregnancy in RIF patients(P<0.05). Conclusion Patients with RIF demonstrate an immune-inflammatory imbalance in the endometrial microenvironment. Serum FSH and AMH levels, as well as post-transfer IL-1β and IFN-γ levels, serve as independent predictors of FET pregnancy outcomes.

Key words: Recurrent implantation failure, Frozen embryo transfer, Endometrial microenvironment, Pregnancy outcome

CLC Number: 

  • R711.6
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