Yamaya Ayano, Fukui Atsushi, Kawai Kiyotaka, Yano Mizuho, Honda Haruka, Nakagawa Kohei, Kamei Hidetake, Omote Maya, Wakimoto Yu, Mabuchi Seiji
Department of Obstetrics and Gynecology Hyogo Medical University Nishinomiya Hyogo Japan.
Reproductive Medicine, Kameda IVF Clinic Makuhari Chiba Chiba Japan.
Reprod Med Biol. 2025 Jun 18;24(1):e12662. doi: 10.1002/rmb2.12662. eCollection 2025 Jan-Dec.
To compare the effects of intravenous immunoglobulin (IVIG) and lipid emulsion (LE) therapies on reproductive failure such as recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF) associated with natural killer (NK) cell abnormalities.
NK cell abnormalities were defined as peripheral blood NK (pNK) cell activity of 40% or higher and CD16/CD56 uterine NK (uNK) cells at 18% or higher. IVIG and LE were administered to RPL and RIF patients. In patients undergoing IVF-ET, treatment was initiated either before ET, on ET day, or after ET.
Implantation rates of 48.3% and 47.8% were revealed in the IVIG and LE groups, respectively, with no significant difference. For patients with RPL, live birth rates were 75.0% for the IVIG group and 72.5% for the LE group, with no significant difference. For timings of administration before ET, on ET day, or after ET, the clinical pregnancy rates were 47.6%, 0%, and 0%, respectively, in the IVIG group and 30.0%, 12.5%, and 0%, respectively, in the LE group. Higher clinical pregnancy rates were observed when each treatment was initiated before ET.
Both treatments exhibited comparable therapeutic effects on reproductive disorders associated with NK cell abnormalities.
比较静脉注射免疫球蛋白（IVIG）和脂质乳剂（LE）疗法对与自然杀伤（NK）细胞异常相关的反复妊娠丢失（RPL）和反复种植失败（RIF）等生殖失败的影响。
NK细胞异常定义为外周血NK（pNK）细胞活性达到40%或更高，以及CD16/CD56子宫NK（uNK）细胞达到18%或更高。对RPL和RIF患者给予IVIG和LE治疗。在接受体外受精-胚胎移植（IVF-ET）治疗的患者中，治疗在胚胎移植前、胚胎移植日或胚胎移植后开始。
IVIG组和LE组的种植率分别为48.3%和47.8%，无显著差异。对于RPL患者，IVIG组的活产率为75.0%，LE组为72.5%，无显著差异。对于在胚胎移植前、胚胎移植日或胚胎移植后给药的时间，IVIG组的临床妊娠率分别为47.6%、0%和0%，LE组分别为30.0%、12.5%和0%。在胚胎移植前开始每种治疗时观察到更高的临床妊娠率。
两种治疗方法对与NK细胞异常相关的生殖障碍均表现出相当的治疗效果。
