Institute of Reproduction, Mainzer Strasse, Mainzer Strasse 98-102, Wiesbaden, Germany.
Am J Reprod Immunol. 2010 Mar 1;63(3):263-5. doi: 10.1111/j.1600-0897.2009.00790.x. Epub 2010 Jan 8.
The purpose of this retrospective, observational study was to investigate whether additional treatment with intravenous immunoglobulin (IVIG) increased the rate of successful pregnancies after repeated implantation failure (RIF). The retrospective data were compared with data of patients without IVIG-therapy from the meta-analysis of Clark et al.
A total of 188 women with 226 treatment cycles between 2007 and 2009 were evaluated for IVIG therapy. The percentage of NK cells was measured two times before a new embryo transfer (only women with NK cell percentages >12% were included) and after embryo transfer at a positive pregnancy test.
In comparison with the meta-analysis of Clark et al., we observed a pregnancy rate of 50.5%, an implantation rate of 21% and a miscarriage rate of 16.8%. In 42%/IVIG- patient or 34.9%/embryo transfer, we observed a live born baby. The live born rate per embryo was 16.6%. In accordance with the study of Kwak et al., we indicate a decrease in the NK cells in patients with improved pregnancy outcome.
In a subgroup of RIF-patients with high level of CD56(+) CD16(+) NK-cells the additional application of IVIG leads to a favourable pregnancy outcome.
本回顾性观察研究的目的是探讨重复着床失败（RIF）患者在接受多次胚胎移植（ET）后，是否需要额外使用静脉注射免疫球蛋白（IVIG）来提高妊娠率。本研究的回顾性数据与 Clark 等人的荟萃分析中的数据进行了比较。
对 2007 年至 2009 年间的 188 名接受 226 个治疗周期的患者进行 IVIG 治疗评估。在进行新的胚胎移植前两次（仅纳入 NK 细胞百分比>12%的患者）和阳性妊娠试验后的胚胎移植后，测量 NK 细胞的百分比。
与 Clark 等人的荟萃分析相比，我们观察到的妊娠率为 50.5%，着床率为 21%，流产率为 16.8%。在 42%/IVIG 患者或 34.9%/胚胎移植中，我们观察到有活产婴儿。每个胚胎的活产率为 16.6%。与 Kwak 等人的研究一致，我们发现 NK 细胞数量减少与妊娠结局改善相关。
在 CD56(+)CD16(+) NK 细胞水平较高的 RIF 患者亚组中，额外应用 IVIG 可带来良好的妊娠结局。
