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J Reprod Immunol. 2019 Sep;134-135:28-33. doi: 10.1016/j.jri.2019.07.006. Epub 2019 Aug 9.

The effectiveness of IVIG therapy in pregnancy and live birth rate of women with recurrent implantation failure (RIF): A systematic review and meta-analysis.

Author information

1
Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
2
Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Iran.
3
Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
4
Gynecology Department, Eastern Azerbaijan ACECR ART center, Eastern Azerbaijan branch of ACECR, Tabriz, Iran.
5
Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: Yousefime@tbzmed.ac.ir.

Abstract

Recurrent implantation failure (RIF), as a challenging problem in human reproduction, is widely improved by intravenous immunoglobulin (IVIG), especially in patients with immunologic abnormalities. In this meta-analysis, we evaluated the results of the studies in which RIF women were treated with IVIG, and pregnancy, live birth, miscarriage and implantation rate were assessed as the result of treatment. A systematic search was conducted in MEDLINE (PubMed), Embase, Cochrane Library, Google Scholar, ProQuest and clinicaltrail.gov. Two cohorts, two cross-sectional and one quasi experimental studies were included in this study. Four out of five studies were included in meta-analysis and remained one study was narratively discussed. Data analysis was conducted by RevMan 5.2 software. Our meta-analysis results demonstrated that there was a significant difference in the pregnancy rate of cohorts (OR = 1.82, 95% CI = 1.14-2.89, P = 0.01) and cross-sectional studies (OR = 11.12, 95% CI = 6.43-19.23, P < 0.00001), live birth rate of cohorts (OR = 2.17, 95% CI = 1.30-3.61, P = 0.003) and cross-sectional studies (OR = 7.57, 95% CI = 4.53-12.64, P < 0.00001) in the IVIG group when compared to the control group, but there was no significant difference in the miscarriage rate. In conclusion, IVIG may be a beneficial therapeutic strategy in RIF patients selected according to relevant immunological disturbances. However, final conclusions on the efficiency of the treatment must await prospective, randomized controlled trials of sufficient size.

KEYWORDS:

Immunologic abnormality; Intravenous immunoglobulin; Meta-analysis; Recurrent implantation failure

PMID:
31425838
DOI:
10.1016/j.jri.2019.07.006

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