Intravenous Immunoglobulin for Repeated IVF Failure and Unexplained Infertility

• Published in: American journal of reproductive immunology (1989) 2012-09, Vol.68 (3), p.218-225
• Main Authors: Virro, Michael R., Winger, Edward E., Reed, Jane L.
• Format: Article
• Language: English
• Subjects: Adult; Blastocyst; Blastocyst - drug effects; Blastocyst - immunology; blastocysts; Data processing; Databases, Factual; embryo quality; Embryo Transfer; Embryos; Female; Fertilization; Fertilization in Vitro; Humans; Immunoglobulins; Immunoglobulins, Intravenous - administration & dosage; Immunologic Factors - administration & dosage; immunotherapy; Infertility; Infertility - drug therapy; Infertility - immunology; Intravenous administration; natural killer cell; Ovum - drug effects; Ovum - immunology; Pregnancy; Pregnancy Rate; repeat IVF failure; Statistics; Th1/Th2 ratio; Treatment Failure; unexplained infertility
• ISSN: 1046-7408; 1600-0897
• DOI: 10.1111/j.1600-0897.2012.01169.x

Problem We set out to determine whether intravenous immunoglobulin (IVIG) improves in vitro fertilization (IVF) success rates in women with a difficult history of multiple (≥2) prior IVF failures and /or ‘unexplained’ infertility. Method of study A total of 229 women with multiple IVF failures (3.3 ± 2.1) and/or unexplained infertility (3.8 ± 2.7 years) were given IVIG on the day of egg retrieval, and the subsequent IVF success rates were compared with published success rates from the Canadian database (CARTR). Results The pregnancy rate per IVIG‐treated cycle was 60.3% (138/229), and the live birth rate per IVIG‐treated cycle was 40.2% (92/229). This is a significantly higher success rate compared to the Canadian average (30% live birth rate; CARTR statistics from 2010; P = 0.0012). In cases where a single embryo was transferred, pregnancy rate using IVIG was almost twofold the CARTR pregnancy rate [(61%(20/33) to 34.9% (428/1225)]. In cases where two high quality (≥Grade 3) day 5 blastocysts were transferred, nearly a 100% pregnancy rate was achieved using IVIG (30/31). Conclusion IVIG may be a useful treatment option for patients with previous IVF failure and/ or unexplained infertility. The data confirm previously published studies at other centers.