{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:07:09Z","timestamp":1783948029850,"version":"3.55.0"},"reference-count":53,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:00:00Z","timestamp":1618876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Problem<\/jats:title>\n                    <jats:p>We aimed to assess whether an imbalance of T\u2010helper (Th) 1 and Th2 cells contributes to implantation failure and pregnancy loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method of study<\/jats:title>\n                    <jats:p>\n                      In this cross\u2010sectional study, 197 consecutive patients with a history of repeated implantation failure (RIF) after three or more embryo transfer (ET) cycles and\/or recurrent pregnancy loss (RPL) after two or more clinical pregnancy losses underwent Th cell testing. After excluding 42 women aged \u226544 and 9 with vitamin D supplementation, we recruited 146 women including 79 with RIF and 81 with RPL. Fourteen women had a history of both RIF and RPL. We also recruited 45 fertile women and 40 general infertile women without a history of\n                      <jats:italic>in vitro<\/jats:italic>\n                      fertilization treatment. This study was approved by the local ethics committee.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was no significant difference in IFN\u2010\u03b3\u2010producing Th1 and IL\u20104\u2010producing Th2 cell levels between the fertile and general infertile women, but Th1 cell levels and the Th1\/Th2 cell ratio were significantly higher in the women with \u22654 ET cycles and \u22652 pregnancy losses than in the fertile and general infertile women. In the general infertile women, the total livebirth rates including natural conception after two ET cycles in the normal and high Th1\/Th2 groups (Th1\/Th2 &lt;11.8 and \u226511.8, respectively) were 66.7% and 87.5%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.395).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A high Th1\/Th2 cell ratio was linked to \u22654 implantation failure cycles and \u22652 pregnancy losses but not to general infertility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aji.13429","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T09:02:37Z","timestamp":1617958957000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Increasing number of implantation failures and pregnancy losses associated with elevated Th1\/Th2 cell ratio"],"prefix":"10.1111","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2759-9159","authenticated-orcid":false,"given":"Keiji","family":"Kuroda","sequence":"first","affiliation":[{"name":"Center for Reproductive Medicine and Implantation Research Sugiyama Clinic Shinjuku Tokyo Japan"},{"name":"Department of Obstetrics and Gynecology Juntendo University Faculty of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0874-5894","authenticated-orcid":false,"given":"Koji","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine and Implantation Research Sugiyama Clinic Shinjuku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Horikawa","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine and Implantation Research Sugiyama 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