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ORIGINAL ARTICLE: Treatment with Adalimumab (Humira ® ) and Intravenous Immunoglobulin Improves Pregnancy Rates in Women Undergoing IVF *
Author(s) -
Winger Edward E.,
Reed Jane L.,
Ashoush Sherif,
Ahuja Sapna,
ElToukhy Tarek,
Taranissi Mohamed
Publication year - 2009
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/j.1600-0897.2008.00669.x
Subject(s) - live birth , medicine , pregnancy , adalimumab , infertility , in vitro fertilisation , cytokine , gestation , pregnancy rate , gestational age , group b , gynecology , obstetrics , tumor necrosis factor alpha , biology , genetics
Problem The purpose of this study was to investigate whether treatment with TNF‐α inhibitors and/or intravenous immunoglobulin (IVIG) increases in vitro fertilization (IVF) success rates among young (<38 years) women with infertility and T helper 1/T helper 2 cytokine elevation. Method of study Seventy‐five sub‐fertile women with Th1/Th2 cytokine elevation were divided into four groups: Group I: Forty‐one patients using both IVIG and Adalimumab (Humira ® ), Group II: Twenty‐three patients using IVIG, Group III: Six patients using Humira ® , and Group IV: Five patients using no IVIG or Humira ® . Results The implantation rate (number of gestational sacs per embryo transferred, with an average of two embryos transferred by cycle) was 59% (50/85), 47% (21/45), 31% (4/13) and 0% (0/9) for groups I, II, III and IV respectively. The clinical pregnancy rate (fetal heart activity per IVF cycle started) was 80% (33/41), 57% (13/23), 50% (3/6) and 0% (0/5) and the live birth rate was 73% (30/41), 52% (12/23), 50% (3/6) and 0% (0/5) respectively. There was a significant improvement in implantation, clinical pregnancy and live birth rates for group I versus group IV ( P = 0.0007, 0.0009, and 0.003, respectively) and for group II versus group IV ( P = 0.009, 0.04 and 0.05, respectively). Conclusion The use of a TNF‐α inhibitor and IVIG significantly improves IVF outcome in young infertile women with Th1/Th2 cytokine elevation.