{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:06:53Z","timestamp":1774976813998,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82201859"],"award-info":[{"award-number":["82201859"]}],"id":[{"id":"10.13039\/501100001809","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":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the effect of intrauterine perfusion of dexamethasone (DXM) on pregnancy outcomes in recurrent reproductive failure (RRF) patients with elevated uNK cells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study included 132 RRF patients with elevated uNK cells: 56 patients received DXM treatment and 76 patients refused it in the frozen\u2010thawed embryo transfer cycles. To determine the efficacy of intrauterine perfusion of DXM, multivariate logistic regression models and diagnosis\u2010based subgroup analysis were performed. We also compared the pregnancy outcomes of patients with different responsiveness to DXM treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intrauterine perfusion of DXM significantly improved clinical pregnancy rate (aOR: 3.188, 95% CI: 1.395\u20137.282, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.006) and live birth rate (aOR: 3.176, 95% CI: 1.318\u20137.656, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.010) in RRF patients with elevated uNK cells, but there was no significant association with miscarriage rate. Subgroup analysis revealed that intrauterine perfusion of DXM in patients with recurrent implantation failure (RIF) showed significant improvement in clinical pregnancy rate (aOR: 6.110, 95% CI: 1.511\u201324.713, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.011) and live birth rate (aOR: 9.904, 95% CI: 1.963\u201349.968, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005), but there was insufficient evidence of benefit in recurrent pregnancy loss (RPL) patients. Additionally, uNK cell levels dropped to normal range was achieved in only 35.90% of RRF patients after DXM treatment, no significant difference was found in pregnancy outcomes among patients with different responsiveness to DXM treatment (all <jats:italic>P<\/jats:italic>\u00a0&gt;\u00a0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intrauterine perfusion of DXM was a promising and effective treatment to enhance clinical pregnancy rate and live birth rate in RRF women with abnormally elevated uNK cells, and RIF patients are more likely to benefit than RPL patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13796","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T07:24:50Z","timestamp":1699428290000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Intrauterine perfusion of dexamethasone improves pregnancy outcomes in recurrent reproductive failure patients with elevated uterine natural killer cells. A retrospective cohort study"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0326-5365","authenticated-orcid":false,"given":"Feng","family":"Zhang","sequence":"first","affiliation":[{"name":"Reproductive Medical Center Renmin Hospital of Wuhan University  Wuhan Hubei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuran","family":"Wang","sequence":"additional","affiliation":[{"name":"Second School of Clinical Medicine Guangzhou University of Chinese Medicine  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruochun","family":"Lian","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory for Reproductive Immunology of Peri\u2010implantation Shenzhen Zhongshan Institute for Reproduction and Genetics Shenzhen Zhongshan Urology Hospital  Shenzhen Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1159-9261","authenticated-orcid":false,"given":"Lianghui","family":"Diao","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory for Reproductive Immunology of Peri\u2010implantation Shenzhen Zhongshan Institute for Reproduction and Genetics Shenzhen Zhongshan Urology Hospital  Shenzhen Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuye","family":"Li","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory for Reproductive Immunology of Peri\u2010implantation Shenzhen Zhongshan Institute for Reproduction and Genetics Shenzhen Zhongshan Urology Hospital  Shenzhen Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaya","family":"Wu","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory for Reproductive Immunology of Peri\u2010implantation Shenzhen Zhongshan Institute for Reproduction and Genetics Shenzhen Zhongshan Urology Hospital  Shenzhen Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2032-0901","authenticated-orcid":false,"given":"Tailang","family":"Yin","sequence":"additional","affiliation":[{"name":"Reproductive Medical Center Renmin Hospital of Wuhan University  Wuhan Hubei China"},{"name":"Wuhan University Shenzhen Research Institute Wuhan University Shenzhen Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3862-050X","authenticated-orcid":false,"given":"Chunyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory for Reproductive Immunology of Peri\u2010implantation Shenzhen Zhongshan Institute for Reproduction and Genetics Shenzhen Zhongshan Urology Hospital  Shenzhen Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoad002"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2013.12.006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958\u2010018\u20100414\u20102"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoy004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa317"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmac006"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20215332"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.737878"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deq050"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2011.06.013"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2017.11.018"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.13024"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3892\/mmr.2017.8267"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aax1798"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.821542"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2012.09.017"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2020.103189"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.00556"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01545"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.05.012"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det117"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2018.10.001"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.8755\u20108920.2000.440411.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12766"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2020.01.005"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2023.103822"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.5302"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2018.03.003"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.13242"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102567.2011.03446.x"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/imm.12224"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2017.10.010"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60326-3"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.steroids.2012.05.007"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10875\u2010012\u20109828\u20103"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.R117.777318"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dem141"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2016.04.290"}],"container-title":["American Journal of Reproductive Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aji.13796","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T21:37:14Z","timestamp":1702417034000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aji.13796"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,7]]},"references-count":38,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/aji.13796"],"URL":"https:\/\/doi.org\/10.1111\/aji.13796","archive":["Portico"],"relation":{},"ISSN":["1046-7408","1600-0897"],"issn-type":[{"value":"1046-7408","type":"print"},{"value":"1600-0897","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,7]]},"assertion":[{"value":"2023-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13796"}}