Premium
The Power of Observation
Author(s) -
Clark David A.
Publication year - 2011
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.1600-0897.2010.00963.x
Subject(s) - embryo transfer , causation , embryo , in vitro fertilisation , andrology , live birth , medicine , physiology , gynecology , pregnancy , biology , genetics , political science , law
Citation
Clark DA. The power of observation. Am J Reprod Immunol 2011; 66: 71–75 Problem In the golden age of evidence‐based medicine, how should one view the cohort‐controlled study of IVIG + anti‐TNF‐α (Humira) in recurrent in vitro fertilization (IVF) failure patients with an elevated Th1/Th2 cytokine production ratio. Method Critical analysis of the nature of evidence for causation. Results A better delivery rate and a live birth rate per embryo approaching the estimated maximum possible in patients whose elevated Th1/Th2 ratio corrected to normal compared to those with an incomplete correction is a strong argument for causation. A maximal improvement when treatment was given 61–120 days before embryo transfer suggests a possible mechanism via improving the physiology during follicle development. Conclusion Independent replication to verify results would augment power.