A Comparative Study of Intravenous Immunoglobulin and Lipid Emulsion in Patients With Reproductive Failures Associated With NK Cell Abnormalities

Abstract

Purpose: 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. Methods: NK cell abnormalities were defined as peripheral blood NK (pNK) cell activity of 40% or higher and CD16+/CD56dim 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. Results: 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. Conclusions: Both treatments exhibited comparable therapeutic effects on reproductive disorders associated with NK cell abnormalities.