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Am J Reprod Immunol. 2009 Feb;61(2):113-20. doi: 10.1111/j.1600-0897.2008.00669.x. Epub 2008 Dec 3.

Treatment with adalimumab (Humira) and intravenous immunoglobulin improves pregnancy rates in women undergoing IVF.

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1
Reproductive Medicine and Immunology, Suite 2106, 611 Washington Street, San Francisco, CA 94111, USA. ewinger@sbcglobal.net

Abstract

PROBLEM:

The purpose of this study was to investigate whether treatment with TNF-alpha inhibitors and/or intravenous immunoglobulin (IVIG) increases in vitro fertilization (IVF) success rates among young (<38 years) women with infertility and T helper 1/T helper 2 cytokine elevation.

METHOD OF STUDY:

Seventy-five sub-fertile women with Th1/Th2 cytokine elevation were divided into four groups: Group I: Forty-one patients using both IVIG and Adalimumab (Humira), Group II: Twenty-three patients using IVIG, Group III: Six patients using Humira, and Group IV: Five patients using no IVIG or Humira.

RESULTS:

The implantation rate (number of gestational sacs per embryo transferred, with an average of two embryos transferred by cycle) was 59% (50/85), 47% (21/45), 31% (4/13) and 0% (0/9) for groups I, II, III and IV respectively. The clinical pregnancy rate (fetal heart activity per IVF cycle started) was 80% (33/41), 57% (13/23), 50% (3/6) and 0% (0/5) and the live birth rate was 73% (30/41), 52% (12/23), 50% (3/6) and 0% (0/5) respectively. There was a significant improvement in implantation, clinical pregnancy and live birth rates for group I versus group IV (P = 0.0007, 0.0009, and 0.003, respectively) and for group II versus group IV (P = 0.009, 0.04 and 0.05, respectively).

CONCLUSION:

The use of a TNF-alpha inhibitor and IVIG significantly improves IVF outcome in young infertile women with Th1/Th2 cytokine elevation.

[Indexed for MEDLINE]

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