Immunological landscape of induced pregnancy: cytokine network as predictor of assisted reproductive technology outcomes and target for personalized therapy

Despite the continuous improvement of ongoing assisted reproductive technologies (ART programs), the rates of successful embryo implantation and clinical pregnancy vary greatly, and the frequency of early pregnancy losses remains significant. A key role in implantation and maintenance of pregnancy belongs to the balance of cytokines, disorders of which are an important risk factor for the failure of ART.

The aim of the work is to systematize modern ideas about the role of the cytokine network in the onset and maintenance of induced pregnancy and to assess the clinical significance of the cytokine profile as a tool for predicting and potentially correcting reproductive failures. The material for the analysis was publications indexed in the international databases as Web of Science, Scopus, PubMed and domestic database as RSCI, the search depth was 5 years (2020–2025).

Main provisions. The cytokine network is a fundamental regulator of implantation and maintenance of induced pregnancy. The imbalance towards proinflammatory (Th1) cytokines such as TNF-α, IFN-γ, IL-1 β may be the most significant factor in implantation failures, early pregnancy losses, and pregnancy complications after ART. In contrast, adequate levels of anti-inflammatory and immunoregulatory (Th2/Treg) cytokines IL-10, TGF-β, IL-35, andadequate Treg activity create anoptimal environment for embryo implantation and development, and correlate with favorable outcomes. A personalized approach based on the detection of cytokine imbalance and its targeted correction, including immunomodulation, the use of growth factors, intrauterine administration of Treg, represents a promising strategy to increase the effectiveness of ART and reduce the frequency of reproductive failures.

Conclusion. The results of the analyzed studies make a significant contribution to reproductive immunology, offering scientifically based approaches to improve the effectiveness of ART and reduce the frequency of reproductive failures through the prism of managing the immune landscape of induced pregnancy.

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