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