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Fertil Steril. 2014 Dec;102(6):1650-5.e1. doi: 10.1016/j.fertnstert.2014.08.029. Epub 2014 Sep 23.

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

Author information

1
Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, København, Denmark. Electronic address: nyborg@dadlnet.dk.
2
Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, København, Denmark.
3
Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, København, Denmark; Department of Obstetrics and Gynecology, Aalborg University Hospital, Reberbansgade, Aalborg, Denmark.

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.

KEYWORDS:

ART; IVF/ICSI; IVIg; Recurrent miscarriage; recurrent implantation failure

[Indexed for MEDLINE]

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