Immunomodulatory treatment with intravenous immunoglobulin and prednisone in patients with recurrent miscarriage and implantation failure after in vitro fertilization intracytoplasmic sperm injection

This retrospective cohort study presents the live birth rate in 52 patients with three or more previous pregnancy losses after assisted reproductive techniques who were treated with intravenous immunoglobulin and prednisone concurrent with in vitro fertilization/intracytoplasmic sperm injection.

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Authors

Kathinka Marie Nyborg, M.D., Astrid M. Kolte, M.D., Elisabeth C. Larsen, Ph.D., Ole B. Christiansen, D.M.Sc.

Volume 102, Issue 6, Pages 1650-1655

Abstract

Objective:

To assess outcome in terms of live-birth rate after fresh or frozen IVF/intracytoplasmic sperm injection assisted reproductive technology (ART) cycles where immunomodulation was given to patients with recurrent pregnancy loss after prior ART treatments.

Design:

Retrospective cohort study.

Setting:

Tertiary care university hospital.

Patient(s):

Fifty-two patients with a history of at least three consecutive pregnancy losses after ART who underwent at least one further ART cycle with concurrent immunomodulation in 2003–2012.

Intervention(s):

Immunomodulation with IV immunoglobulin and prednisone starting from before ET and continuing in the first trimester if pregnancy was established.

Main Outcome Measure(s):

Live-birth rate per ET and cumulative live-birth rate after up to five ETs.

Result(s):

Nineteen patients (36.5%) achieved a live birth after the first ET with immunomodulation, and a total of 32 patients achieved a live birth in the study period, resulting in a cumulative live-birth rate of 61.5%. There was no significant difference in baseline and immunological parameters between the patients achieving a live birth or not. The live-birth rate after the first immunomodulated ART cycle in our patients is higher than that reported in a previous study.

Conclusion(s):

Immunomodulation with a combination of IV immunoglobulin and prednisone is a promising treatment for recurrent pregnancy loss after ART, but randomized placebo-controlled trials are needed.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)02119-0/fulltext


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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