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- W2097356162 abstract "The most common reason that IVF is unsuccessful is the failure of embryos to implant.Although embryo abnormality may be responsible in many cases, problems relating to abnormalities in a woman’s immune system may play a part in a significant proportion of these failures. Evidence is emerging that immunologic and immunophenotypic evidence of local and peripheral natural killer[NK] cell activation and T-helper 1[TH1] dominance may be associated with unexplained repeated embryo implantation failure.We have identified women with these problems and treated them with what we consider appropriate immunotherapy.We present our findings. Retrospective review. 284 women with at least 3 unexplained IVF failures had blood tests for NK assay and TH1/TH2 intracellular cytokine ratios,in addition to other tests fo recurrent embryo implantaion failure.NK abnormalities were treated with intravenous immunoglobulin[IVIg] 25G once between day 8-10 of superovulation, repeated if pregnancy test was positive.TH1/TH2 abnormality with raised TNFalpha: IL10 ratios were treated with antiTNFalpha drugs[Infliximab] 200-300mg before IVF. No abnormalities were found in 13 women.105 women had NK abnormality and had IVIg.9 out of 12 egg recipients[75%]so treated conceived.93 had IVF with own eggs[mean age=37.6yrs, mean no. failed IVF=6.4]-51[54.8%] coceived. 37 women[mean age=37.3yrs,mean no. failed IVF=6.6] had raised TNFalpha/IL10 ratios and were treated with Infliximab.2 out 4 egg recipients so treated[50%]conceived and 20 out of 33 treated with own eggs[60.6%]conceived.49 women have delivered and all babies are fine. A pregnancy rate in the region of 10% would be expected in women with similar IVF profiles. Women with repeated unexplained IVF failures seem to have a high incidence of abnormalities on immunological testing for NK assay and TH1 dominance.Immunotherapy with IVIg and anti TNFalpha drugs seem to improve IVF outcome.More research is however urgently needed on this area." @default.
- W2097356162 created "2016-06-24" @default.
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- W2097356162 date "2005-09-01" @default.
- W2097356162 modified "2023-10-16" @default.
- W2097356162 title "Improved Outcome in Unexplained Repeated IVF Failures After Immunotherapy With Intravenous Immunoglobulin[IVIg] and AntiTNFalpha Drugs" @default.
- W2097356162 doi "https://doi.org/10.1016/j.fertnstert.2005.07.680" @default.
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