See Commentary on page 107
ORIGINAL ARTICLE: Treatment with Adalimumab (Humira®) and Intravenous Immunoglobulin Improves Pregnancy Rates in Women Undergoing IVF*
Article first published online: 4 DEC 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
American Journal of Reproductive Immunology
Volume 61, Issue 2, pages 113–120, February 2009
How to Cite
Winger, E. E., Reed, J. L., Ashoush, S., Ahuja, S., El-Toukhy, T. and Taranissi, M. (2009), ORIGINAL ARTICLE: Treatment with Adalimumab (Humira®) and Intravenous Immunoglobulin Improves Pregnancy Rates in Women Undergoing IVF. American Journal of Reproductive Immunology, 61: 113–120. doi: 10.1111/j.1600-0897.2008.00669.x
- Issue published online: 11 JAN 2009
- Article first published online: 4 DEC 2008
- Submitted September 8, 2008; accepted October 29, 2008.
- intravenous immunoglobulin;
- Th1/Th2 ratio;
- tumor necrosis factor-α inhibitor;
- tumor necrosis factor-α
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.