Received March 26, 2026
Accepted April 14, 2026

The letter to the editor acknowledges the relevance of Monteleone’s concerns about the need for stricter methodological standards in reproductive immunology but argues that his perspective is overly restrictive. The authors contend that, despite existing limitations and heterogeneity in the field, there have been meaningful advances and that international guidelines support the cautious, evidence-based use of immunological interventions in selected patients. They highlight that recent guidelines recognize the potential benefits of treatments such as intravenous immunoglobulin in specific cases, as well as the role of immune biomarkers in identifying patient subgroups. Although challenges in standardization remain, these biomarkers have been consistently associated with adverse reproductive outcomes. Finally, while agreeing with the ethical concerns regarding the indiscriminate use of insufficiently validated therapies, the authors warn against dismissing potentially beneficial interventions. They advocate for a balanced approach that includes more robust clinical trials, standardization of methods, and interdisciplinary collaboration, framing reproductive immunology as an emerging field within precision medicine.