Immune factors and treatment options for recurrent graft failure

  (1) Test items for immune infertility: After excluding chromosomal abnormalities, tubal factors, ovarian factors, uterine cavity factors, blood group factors, cervical factors, male semen factors, TORCH infection, mycoplasma and chlamydia, anti-sperm antibodies, anti-endometrial antibodies (AEA), zona pellucida antibodies or anti-ovarian antibodies, anti-HCG antibodies, anti-trophoblast antibodies (TB) and anti-thyroid antibodies. (TB), and anti-thyroid antibodies.  (2) Tests for recurrent spontaneous miscarriage, fetal abortion and recurrent transplant failure: After excluding chromosomal abnormalities, tubal factors, ovarian factors, uterine cavity factors, blood group factors, cervical factors, male semen factors, TORCH infection and mycoplasma and chlamydia, anti-cardiolipin antibodies, D-dimer, platelet focus rate, anti-nuclear antibodies (ANA), lupus anticoagulation factor (LAC), anti-beta-2-glycoprotein (AEA), anti-beta-2-glycoprotein, anti-beta-2-glycoprotein, anti-beta-2-glycoprotein and anti-beta-2-glycoprotein. ), anti-β2-glycoprotein 1 antibody, zona pellucida antibody, anti-thyroid antibody, confinement antibody, uniqueness antibody, confinement efficiency, and Treg test.  2. Treatment: (1) Treatment of antiphospholipid antibody positivity: Western medicine is based on anticoagulation therapy, mostly using favalin, heparin, low molecular heparin, aspirin, etc., which have increased the risk of bleeding. The combination of Chinese and Western medicine has unique advantages.  (2) Zona pellucida antibody-positive: Chinese medicine Zhi Bai Di Huang Wan.  (3) For patients with anti-sperm immune infertility, isolation therapy (such as condom), immunosuppressive therapy, intrauterine insemination or in vitro fertilization are recommended.  (4) Treatment of low closed antibody and unique antibody: the principle is to induce closed antibody production.  (①Chinese herbal prescriptions: such as Chuanbei mother, Tianma, whole scorpion, centipede, sedum, American ginseng, Panax ginseng, etc.  ②Cyclosporine + Daphne: High dose of cyclosporine (CsA) acts as an immunosuppressive agent, while small dose of cyclosporine acts as an immune enhancer.CsA inhibits the proliferation of peripheral lymphocytes, the expression of IL-2 and IFN-γ in a dose-dependent manner, and also affects the activity of NK cells.The mechanism of action on the immune system is complex, and may induce by affecting multiple cells, multiple molecules immune tolerance.  ③ Active immunotherapy: immunotherapy with spousal lymphocytes or donor lymphocytes. Before treatment, it is important to make sure that the male partner does not have infectious diseases (e.g. hepatitis, HIV, etc.), to draw about 50 ml of venous blood from the male partner, to isolate lymphocytes (sterile, laminar flow processing room required), or after in vitro induction (culture), to be injected into the female partner’s double forearm skin to induce the production of closed antibodies, which are immunoprotective to the embryo This antibody is immunoprotective to the embryo.  Active immunotherapy is performed every 3-4 weeks (avoiding menstruation), and 3 sessions are considered as a course of treatment. At the end of the course, the level of antibody is rechecked and the doctor will decide whether to schedule a pregnancy or proceed to the next course of treatment based on the level of antibody; further immunotherapy is required during pregnancy until the 5th-6th month of pregnancy.  Three days of in vitro induction followed by intradermal injection into the woman’s forearm is superior to same-day injection treatment.