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The 116 women with RIF after the OPTIMUM treatment strategy were 38.3±3.8years old and had an implantation failure history over 5 (3-19) ET cycles. Implantation testing identified impaired intrauterine circumstances in 75 women (64.7%), an aberrant elevated Th1/Th2 cell ratio in 56 women (48.3%), and thyroid abnormalities in 33 women (28.4%). Cumulative ongoing pregnancy rates including spontaneous pregnancy in the patients aged40 and≥40years were 72.7% and 45.5% within two ET cycles, respectively. The pregnancy outcomes in the OPT

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