A unique endometrial immune reaction should occur to promote the human embryo implantation. We postulated that an immune disequilibrium may impact the initial dialogue between the mother and her embryo. In 2012, we set a method of uterine immune profiling for patients with unexplained repeated implantation failures (RIF). The method documents the local Th-1/ Th-2 equilibrium and the recruitment and state of maturation/activation of uNK cells. In function of the disequilibrium observed, personalization of assisted reproductive treatments was suggested.

As the concept of personalization in function of the uterine immune profile had never been proposed, a large cohort study and a controlled cohort study were first conducted in RIF patients. 80 % of the RIF patients showed a local disequilibrium if compared to fertile controls. The local disequilibrium was identified in 3 categories: over-immune activation in 45 %, low- local immune activation in 25 % and mixed profile in 10 %. Personalization of treatments in function of the immune profile allowed to restore a live birth rate by 40 % at the following embryo transfer. RIF patients with endometriosis show some particularities regarding their immune profiles. We also suggested that immunotherapy (corticoids, intralipids) may have targeted indications based on a better understanding of the immune type of disequilibrium documented.

Personalization of treatments for RIF patients seems to be essential to promote the subsequent live birth rate. The endometrial immune profiling is an innovative method aiming to detect a local immune disequilibrium and, if present, to test preventively its correction under treatment.

应发生独特的子宫内膜免疫反应以促进人胚胎着床。我们假设免疫不平衡可能会影响母亲和她的胚胎之间的初始对话。2012 年，我们为不明原因的重复植入失败 (RIF) 患者设定了一种子宫免疫分析方法。该方法记录了局部 Th-1/Th-2 平衡以及 uNK 细胞成熟/激活的募集和状态。根据观察到的不平衡，建议对辅助生殖治疗进行个性化。

由于从未提出过子宫免疫功能个性化的概念，因此首先在 RIF 患者中进行了一项大型队列研究和一项对照队列研究。如果与可育对照相比，80% 的 RIF 患者表现出局部不平衡。局部不平衡分为 3 类：45% 的过度免疫激活，25% 的低局部免疫激活和 10% 的混合型。根据免疫特征进行个性化治疗，可以在接下来的胚胎移植中恢复 40% 的活产率。患有子宫内膜异位症的 RIF 患者在其免疫特征方面表现出一些特殊性。我们还建议，基于对记录的不平衡免疫类型的更好理解，免疫疗法（皮质激素、脂类药物）可能具有针对性的适应症。

RIF 患者的个性化治疗似乎对于提高随后的活产率至关重要。子宫内膜免疫分析是一种创新方法，旨在检测局部免疫不平衡，如果存在，则在治疗中预防性地测试其纠正。