Clinical experience with IVIg Rx in patients with prior failed IVF pregnancies: Report of 30 consecutive patients

PROBLEM: This study reviews one practitioner's experience with intravenous immunoglobulin (IVIg) therapy in the in-vitro fertilization (IVF) cycles of 30 patients with previous IVF failures. METHOD OF STUDY: Thirty patients had undergone 82 prior assisted reproducti ve technology (ART) cycles (mean 3.9 +/- 2 failed ART cycles, median 3.0, r ange 1-8) yielding one term birth, one loss at 22.5 weeks, and five chemica l pregnancies. These patients underwent comprehensive clinical and laborato ry evaluation, including immunologic workup, and were accepted for IVIg the rapy in their next IVF cycle. RESULTS: A total of 40 cycles were treated. Twenty-four (60%); of the IVIg- treated IVF cycles showed a positive human chorionic gonadotropin test. Com paring the IVIg cycles to the untreated ART cycles, there were no differenc es in the number of embryos transferred, fertilized embryos, or eggs. Eight y-six percent of the cases with confirmed implantation delivered; there was one chemical pregnancy, one 20-week spontaneous fetal death, and one triso my. Five (24%) of the 21 pregnant patients delivered at 30-36 weeks. The re maining 13 delivered at term. Only three (11%) had no positive immune test. CONCLUSION: In what may be a selected population of IVF patients (with high incidence of abnormal immune testing), early IVIg therapy may be associate d with the improved success of IVF, and the high rate of live birth.