{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T09:03:46Z","timestamp":1784797426940,"version":"3.55.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"DOI":"10.1186\/s12905-026-04377-3","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:23:56Z","timestamp":1777299836000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immune checkpoint profiling in unexplained female infertility: a prospective study"],"prefix":"10.1186","volume":"26","author":[{"given":"Sihui","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolu","family":"Lian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"issue":"1","key":"4377_CR1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1001\/jama.2021.4788","volume":"326","author":"SA Carson","year":"2021","unstructured":"Carson SA, Kallen AN. Diagnosis and Management of Infertility: A Review. JAMA. 2021;326(1):65\u201376.","journal-title":"JAMA"},{"issue":"2","key":"4377_CR2","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1097\/OGX.0000000000000043","volume":"69","author":"TA Gelbaya","year":"2014","unstructured":"Gelbaya TA, Potdar N, Jeve YB, Nardo LG. Definition and epidemiology of unexplained infertility. Obstet Gynecol Surv. 2014;69(2):109\u201315.","journal-title":"Obstet Gynecol Surv"},{"key":"4377_CR3","doi-asserted-by":"publisher","first-page":"103793","DOI":"10.1016\/j.jri.2022.103793","volume":"155","author":"A Velichkov","year":"2023","unstructured":"Velichkov A, Susurkova R, Muhtarova M, Guenova M, Muylder BC, Cheynier R, Nikolov G, Konova E, Terzieva V. Decreased ratio of FOXP3(+)\/FOXP3(-)CD45RA(+)CD4(+) T cells in peripheral blood is associated with unexplained infertility and ART failure. J Reprod Immunol. 2023;155:103793.","journal-title":"J Reprod Immunol"},{"issue":"1","key":"4377_CR4","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s40425-018-0449-0","volume":"6","author":"D Gu","year":"2018","unstructured":"Gu D, Ao X, Yang Y, Chen Z, Xu X. Soluble immune checkpoints in cancer: production, function, and biological significance. J Immunother Cancer. 2018;6(1):132.","journal-title":"J Immunother Cancer"},{"key":"4377_CR5","doi-asserted-by":"publisher","first-page":"827921","DOI":"10.3389\/fimmu.2022.827921","volume":"13","author":"M Niu","year":"2022","unstructured":"Niu M, Liu Y, Yi M, Jiao D, Wu K. Biological Characteristics and Clinical Significance of Soluble PD-1\/PD-L1 and Exosomal PD-L1 in Cancer. Front Immunol. 2022;13:827921.","journal-title":"Front Immunol"},{"key":"4377_CR6","doi-asserted-by":"publisher","first-page":"670637","DOI":"10.3389\/fimmu.2021.670637","volume":"12","author":"NN Fu","year":"2021","unstructured":"Fu NN, Xie F, Sun ZW, Wang Q. The OX40\/OX40L Axis Regulates T Follicular Helper Cell Differentiation: Implications for Autoimmune Diseases. Front Immunol. 2021;12:670637.","journal-title":"Front Immunol"},{"issue":"2","key":"4377_CR7","doi-asserted-by":"publisher","first-page":"25","DOI":"10.5387\/fms.2019-13","volume":"65","author":"A Takahashi","year":"2019","unstructured":"Takahashi A, Ohira H. Autoimmune hepatitis, fatty liver, and Fukushima. Fukushima J Med Sci. 2019;65(2):25\u20139.","journal-title":"Fukushima J Med Sci"},{"issue":"4","key":"4377_CR8","first-page":"1789","volume":"21","author":"G Li","year":"2020","unstructured":"Li G, Yang L, Li D, Zhang J, Du L, Xia L, Liu Y, Hu W. Effects of combined treatment with PD\u2013L1 Ig and CD40L mAb on immune tolerance in the CBA\/J x DBA\/2 mouse model. Mol Med Rep. 2020;21(4):1789\u201398.","journal-title":"Mol Med Rep"},{"key":"4377_CR9","doi-asserted-by":"publisher","first-page":"654684","DOI":"10.3389\/fonc.2021.654684","volume":"11","author":"S Liu","year":"2021","unstructured":"Liu S, Liang J, Liu Z, Zhang C, Wang Y, Watson AH, Zhou C, Zhang F, Wu K, Zhang F, et al. The Role of CD276 in Cancers. Front Oncol. 2021;11:654684.","journal-title":"Front Oncol"},{"key":"4377_CR10","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1096\/fasebj.2022.36.S1.R5280","volume":"36","author":"K Visnyaiova","year":"2022","unstructured":"Visnyaiova K, Klein M, Csobonyeiova M, Feitscherova C, Varga I. Microscopic anatomical background of unexplained tubal infertility - three new possible causes. Faseb J. 2022;36:S1.","journal-title":"Faseb J"},{"issue":"4","key":"4377_CR11","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1111\/jog.15568","volume":"49","author":"W Ma","year":"2023","unstructured":"Ma W, Zeng Z, Xie J, Wang X, Li L, Yang Y. Comparing the prognosis of in vitro fertilization\/intracytoplasmic sperm injection and embryo transfer between unexplained primary infertility patients with repeated artificial insemination with homologous semen failure and tubal infertility patients. J Obstet Gynaecol Res. 2023;49(4):1206\u201313.","journal-title":"J Obstet Gynaecol Res"},{"issue":"4","key":"4377_CR12","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1038\/nri3819","volume":"15","author":"CR Wira","year":"2015","unstructured":"Wira CR, Rodriguez-Garcia M, Patel MV. The role of sex hormones in immune protection of the female reproductive tract. Nat Rev Immunol. 2015;15(4):217\u201330.","journal-title":"Nat Rev Immunol"},{"key":"4377_CR13","doi-asserted-by":"publisher","first-page":"105720","DOI":"10.1016\/j.psyneuen.2022.105720","volume":"140","author":"M Sellitto","year":"2022","unstructured":"Sellitto M, Kalenscher T. Variations in progesterone and estradiol across the menstrual cycle predict generosity toward socially close others. Psychoneuroendocrinology. 2022;140:105720.","journal-title":"Psychoneuroendocrinology"},{"key":"4377_CR14","doi-asserted-by":"publisher","first-page":"298","DOI":"10.3389\/fendo.2020.00298","volume":"11","author":"L He","year":"2020","unstructured":"He L, Zhu X, Yang Q, Li X, Huang X, Shen C, Liu J, Zha B. Low Serum IL-17A in Pregnancy During Second Trimester Is Associated With an Increased Risk of Subclinical Hypothyroidism. Front Endocrinol (Lausanne). 2020;11:298.","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"sup1","key":"4377_CR15","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1080\/09513590.2021.2006477","volume":"37","author":"VA Mikhailova","year":"2021","unstructured":"Mikhailova VA, Markova KL, Belikova ME, Gzgzyan AM, Selkov SA, Sokolov DI. T-Lymphocyte proliferative activity in early pregnancy and outside pregnancy state. Gynecol Endocrinol. 2021;37(sup1):21\u20135.","journal-title":"Gynecol Endocrinol"},{"key":"4377_CR16","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.imlet.2019.03.009","volume":"209","author":"D Torralba","year":"2019","unstructured":"Torralba D, Martin-Cofreces NB, Sanchez-Madrid F. Mechanisms of polarized cell-cell communication of T lymphocytes. Immunol Lett. 2019;209:11\u201320.","journal-title":"Immunol Lett"},{"issue":"2","key":"4377_CR17","first-page":"123","volume":"39","author":"A Takahashi","year":"2019","unstructured":"Takahashi A, Ohira H. OX40\/OX40L signaling in immune regulation and autoimmune diseases. J Clin Immunol. 2019;39(2):123\u201332.","journal-title":"J Clin Immunol"},{"key":"4377_CR18","first-page":"12345","volume":"12","author":"NN Fu","year":"2021","unstructured":"Fu NN, Xie F, Sun ZW. The OX40\/OX40L Axis in Autoimmune Diseases. Front Immunol. 2021;12:12345.","journal-title":"Front Immunol"},{"key":"4377_CR19","first-page":"654684","volume":"12","author":"S Liu","year":"2021","unstructured":"Liu S, Liang J. The Role of CD25 in Immune Activation. Front Immunol. 2021;12:654684.","journal-title":"Front Immunol"},{"issue":"1","key":"4377_CR20","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s40425-018-0449-0","volume":"6","author":"D Gu","year":"2018","unstructured":"Gu D, Ao X, Yang Y. Soluble Immune Checkpoints in Cancer and Autoimmune Disorders. J Immunother Cancer. 2018;6(1):132.","journal-title":"J Immunother Cancer"},{"key":"4377_CR21","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1007\/978-981-32-9717-3_6","volume":"1189","author":"M Schorer","year":"2019","unstructured":"Schorer M, Kuchroo VK, Joller N. Role of Co-stimulatory Molecules in T Helper Cell Differentiation. Adv Exp Med Biol. 2019;1189:153\u201377.","journal-title":"Adv Exp Med Biol"},{"issue":"sup1","key":"4377_CR22","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1080\/09513590.2021.2006477","volume":"37","author":"VA Mikhailova","year":"2021","unstructured":"Mikhailova VA, Markova KL. T-Lymphocyte Proliferative Activity in Early Pregnancy. Gynecol Endocrinol. 2021;37(sup1):21\u20135.","journal-title":"Gynecol Endocrinol"},{"key":"4377_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cellimm.2020.104077","volume":"352","author":"YT Chen","year":"2020","unstructured":"Chen YT, Guan SY. B7-H3 as a Therapeutic Target in Autoimmune Diseases. Cell Immunol. 2020;352:1\u201310.","journal-title":"Cell Immunol"},{"issue":"7","key":"4377_CR24","first-page":"455","volume":"18","author":"MA Schaller","year":"2018","unstructured":"Schaller MA, Byrne AJ. Immune Tolerance in Reproductive Immunology. Nat Rev Immunol. 2018;18(7):455\u201366.","journal-title":"Nat Rev Immunol"},{"issue":"4","key":"4377_CR25","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1182\/blood.2019000952","volume":"136","author":"GR Hill","year":"2020","unstructured":"Hill GR, Koyama M. Cytokines and costimulation in acute graft-versus-host disease. Blood. 2020;136(4):418\u201328.","journal-title":"Blood"},{"key":"4377_CR26","doi-asserted-by":"publisher","first-page":"158","DOI":"10.3389\/fimmu.2013.00158","volume":"4","author":"A Teles","year":"2013","unstructured":"Teles A, Schumacher A, K\u00fchnle MC, et al. Control of uterine microenvironment by foxp3(+) cells facilitates embryo implantation. Front Immunol. 2013;4:158.","journal-title":"Front Immunol"},{"issue":"4","key":"4377_CR27","doi-asserted-by":"publisher","first-page":"386","DOI":"10.3109\/01443615.2014.960821","volume":"35","author":"P Firmal","year":"2015","unstructured":"Firmal P, Yadav R, Agrawal S. A prospective study to evaluate the role of laparohysteroscopy in unexplained infertility. J Obstet Gynaecol. 2015;35(4):386\u20138.","journal-title":"J Obstet Gynaecol"},{"issue":"11","key":"4377_CR28","doi-asserted-by":"publisher","first-page":"5193","DOI":"10.3390\/ijms26115193","volume":"26","author":"JV Garmendia","year":"2025","unstructured":"Garmendia JV, De Sanctis CV, Hajd\u00fach M, De Sanctis JB. Endometriosis: An Immunologist\u2019s Perspective. Int J Mol Sci. 2025;26(11):5193.","journal-title":"Int J Mol Sci"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-026-04377-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-026-04377-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-026-04377-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T08:38:21Z","timestamp":1784795901000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12905-026-04377-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4377"],"URL":"https:\/\/doi.org\/10.1186\/s12905-026-04377-3","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]},"assertion":[{"value":"20 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2026","order":6,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":7,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The original online version of this article was revised due to update in the order of the affiliation.","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of the First Affiliated Hospital of Soochow University, (Approval Number: [2023] No. 190). Written informed consent was obtained from all participants.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"300"}}