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Experience in IVI g Therapy for Selected Women with Recurrent Reproductive Failure and NK Cell Expansion
Author(s) -
RamosMedina Rocio,
GarcíaSegovia Aurea,
Gil Juana,
Carbone Javier,
Aguarón de la Cruz Angel,
Seyfferth Ansgar,
Alonso Bárbara,
Alonso Jorge,
León Juan A.,
Alecsandru Diana,
Meliá Elena,
Carrillo de Albornoz Elena,
Ordoñez Daniel,
Santillán Isabel,
Verdú Victoria,
Garcia Ruiz de Morales Jose Maria,
LópezHoyos Marcos,
López Larios Arturo,
Sampalo Almudena,
Caballero Pedro,
Ortiz Quintana Luis,
FernándezCruz Eduardo,
SánchezRamón Silvia
Publication year - 2014
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12217
Subject(s) - live birth , recurrent miscarriage , medicine , miscarriage , immunology , andrology , gestation , pregnancy , biology , genetics
Problem Recurrent reproductive failure ( RRF ) has been associated with expansion of circulating NK cells, key cells for maternal tolerance, decidual vasculogenesis and embryo growth. This study reports our experience in intravenous immunoglobulin ( IVI g) therapy of a large cohort of women with RRF with expanded circulating NK and/or NKT ‐like cells (blood NKT cells are a heterogeneous subset of T cells that share properties of both T cells and NK cells). Method of study Observational study of RRF women with NK or NKT ‐like expansion (>12% or 10% cutoff levels of total lymphocytes, respectively), treated with IVI g for the next gestation. Results By multivariant logistic regression analysis after adjusting for age, NK cells subsets and other therapies, IVI g significantly improved the live birth rate to 96.3% in women with recurrent miscarriage ( RM ) compared with 30.6% in case not receiving IVI g ( P < 0.0001). In women with recurrent implantation failure ( RIF ), in comparison with women not receiving IVI g, treatment increased the pregnancy rate from 26.2 to 93.8% ( P ≤ 0.0001) and the live birth rate from 17.9 to 80.0% in RIF ( P ≤ 0.0001). Conclusions Immunomodulation with IVI g in our selected group of RRF patients with immunologic alterations enhanced clinical pregnancy and live birth rates. Our results may facilitate the design of future clinical trials of IVI g in this pathology.