Elevated Preconception CD56+16+ and/or Th1:Th2 Levels Predict Benefit from IVIG Therapy in Subfertile Women Undergoing IVF

• Published in: American journal of reproductive immunology (1989) 2011-11, Vol.66 (5), p.394-403
• Main Authors: Winger, Edward E., Reed, Jane L., Ashoush, Sherif, El-Toukhy, Tarek, Ahuja, Sapna, Taranissi, Mohamed
• Format: Article
• Language: English
• Subjects: Adult; Age; Blood; CD56 antigen; CD56 Antigen - metabolism; Clinical trials; Cytokines - metabolism; Embryo Implantation; Embryo Transfer; Embryos; Female; Fertilization in Vitro - methods; Fetuses; Heart rate; Humans; IFN-γ; Immunoglobulins; Immunoglobulins, Intravenous - immunology; Immunoglobulins, Intravenous - therapeutic use; immunotherapy; Infertility - immunology; Infertility - therapy; Intravenous administration; IVIG; Live Birth; natural killer cell; Preconception Care; Predictive Value of Tests; Pregnancy; Pregnancy Rate; Th1 Cells - immunology; Th2 Cells - immunology; TNF-α; Treatment Outcome
• ISSN: 1046-7408; 1600-0897
• DOI: 10.1111/j.1600-0897.2011.01018.x

Citation Winger EE, Reed JL, Ashoush S, El‐Toukhy T, Ahuja S, Taranissi M. Elevated preconception CD56+16+ and/or Th1:Th2 levels predict benefit from IVIG therapy in subfertile women undergoing IVF. Am J Reprod Immunol 2011; 66: 394–403 Problem  We sought to answer two questions: First, is there a group of patients who benefit from intravenous immunoglobulin (IVIG) in IVF? Second can this group of patients be identified by preconception blood testing? Method of study  A total of 202 IVF cycles in subfertile women were divided into four groups. Group I: 62 cycles with preconception Th1:Th2 ratio and/or % CD56+ cell elevation using IVIG; Group II: 27 cycles with similar Th1:Th2 and/or % CD56+ cell elevation not using IVIG; Group III: 71 cycles with normal Th1:Th2 and/or % CD56+ cell levels using IVIG; Group IV: 42 cycles with normal Th1:Th2 and % CD56+ levels not using IVIG. These groups were similar with regard to patient age, diagnosis, and past failure history. Results  The implantation rate (number of gestational sacs per embryo transferred, with an average of two embryos transferred per cycle) was 45% (55/123), 22% (12/54), 54% (75/139), and 48% (40/84) for Groups I–IV, respectively. The clinical pregnancy rate (fetal heart activity per IVF cycle started) was 61% (38/62), 26% (7/27), 69% (49/71), and 71% (30/42), respectively. The live birth rate was 58% (36/62), 22% (6/27), 61% (43/71), and 71% (30/42), respectively, and the live birth per embryo transferred was 40% (49/123), 13% (7/24), 43% (60/139), and 48% (40/84), respectively. There was a significant improvement in implantation, clinical pregnancy, live birth rate and live birth rate per embryo transferred for Group I versus Group II (P = 0.0032, 0.0021, 0.0017, and 0.0002, respectively) and for Group II versus Group IV (P = 0.0021, 0.0002,