Effects of intralipid infusions on anti-trophoblast antibody (ATAb)-activities in patients with recurrent pregnancy loss: An observational report

Abstract

Problem: Some studies suggest intravenous intralipid infusions (IVIL) to be effective in the treatment of immune-mediated pregnancy failure. To this date it remains to be established, how IVIL might protect pregnancy and therefore a specific subgroup of RPL patients that might benefit from IVIL has not been defined. Anti-trophoblast antibodies (ATAb) have been associated with RPL and appear to mediate immune pathology. We have shown, that ATAb in vitro decrease HCG- and progesterone production pointing to a mechanism how ATAb interfere with normal pregnancies. We have measured ATAb-activities in patients undergoing off label IVIL-treatment. Method of study: Ten RPL-patients with positive ATAb, determined by using the choriocarcinoma cellline JEG-3 and flow cytometry as described before, and otherwise unexplained RPL, received off-label IVIL during pregnancy. Two ATAb-positive RPL patients preferred expectant management. In addition, ATAb-activity was studied in pregnancies of two healthy ATAb-negative volunteers without miscarriages. Results: In RPL patients receiving IVIL, relative ATAb-activity decreased from an average of 56.8±17.0% to 20.8±11.0% (P