학술논문
Intravenous immunoglobulin for patients with unexplained recurrent implantation failure: a 6-year single center retrospective review of clinical outcomes.
Document Type
Article
Author
Peero, Einav Kadour; Banjar, Shorooq; Khoudja, Rabea; Ton-leclerc, Shaonie; Beauchamp, Coralie; Benoit, Joanne; Beltempo, Marc; Dahan, Michael H.; Gold, Phil; Kadoch, Isaac Jacques; Jamal, Wael; Laskin, Carl; Mahutte, Neal; Phillips, Simon; Sylvestre, Camille; Reinblatt, Shauna; Mazer, Bruce D.; Buckett, William; Genest, Genevieve
Source
Subject
*EMBRYO implantation
*BLASTOCYST
*TREATMENT effectiveness
*LOGISTIC regression analysis
*RETROSPECTIVE studies
*INTRAVENOUS immunoglobulins
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Language
ISSN
2045-2322
Abstract
The effectiveness of intravenous immunoglobulin (IVIg) for patients with unexplained recurrent implantation failure (uRIF) remains debated. We retrospectively analysed outcomes of uRIF patients treated with IVIg compared to a separate control uRIF cohort within our center (01/2014–12/2021). Primary outcomes included live birth, miscarriage, or transfer failure. We documented IVIg side effects and maternal/fetal outcomes. Logistic regression analysis was used to assess for association of IVIg exposure with outcomes and adjust for confounders. The study included 143 patients, with a 2:1 ratio of controls to patients receiving IVIg treatment. Patient characteristics were similar between groups. There was higher live birth rate (LBR) in patients receiving IVIg (32/49; 65.3%) compared to controls (32/94; 34%); p < 0.001). When stratifying patients into moderate and severe uRIF (respectively 3–4 and ≥ 5 previous good quality blastocyst transfer failures), only patients with severe uRIF benefited from IVIg (LBR (20/29 (69%) versus 5/25 (20%) for controls, p = 0.0004). In the logistic regression analysis, IVIg was associated with higher odds of live birth (OR 3.64; 95% CI 1.78–7.67; p = 0.0004). There were no serious adverse events with IVIg. IVIg can be considered in well selected patients with ≥ 5 previous unexplained, high quality blastocyst transfer failures. A randomized controlled trial is needed to confirm these findings. [ABSTRACT FROM AUTHOR]