title: CD3-CD56+CD16+ natural killer cells and improvement of pregnancy outcome in IVF/ICSI failure after additional IVIG-treatment.
abstract: OBJECTIVE
  The purpose of this retrospective, observational study was to investigate whether additional treatment with intravenous immunoglobulin (IVIG) increased the rate of successful pregnancies after repeated implantation failure (RIF). The retrospective data were compared with data of patients without IVIG-therapy from the meta-analysis of Clark et al.
  
  
  METHODS
  A total of 188 women with 226 treatment cycles between 2007 and 2009 were evaluated for IVIG therapy. The percentage of NK cells was measured two times before a new embryo transfer (only women with NK cell percentages >12% were included) and after embryo transfer at a positive pregnancy test.
  
  
  RESULTS
  In comparison with the meta-analysis of Clark et al., we observed a pregnancy rate of 50.5%, an implantation rate of 21% and a miscarriage rate of 16.8%. In 42%/IVIG- patient or 34.9%/embryo transfer, we observed a live born baby. The live born rate per embryo was 16.6%. In accordance with the study of Kwak et al., we indicate a decrease in the NK cells in patients with improved pregnancy outcome.
  
  
  CONCLUSIONS
  In a subgroup of RIF-patients with high level of CD56(+) CD16(+) NK-cells the additional application of IVIG leads to a favourable pregnancy outcome.
authors.affiliation: Institute of Reproduction, Mainzer Strasse, Mainzer Strasse 98-102, Wiesbaden, Germany. lothar.heilmann@googlemail.com
authors.forename: Lothar
authors.initials: L
authors.lastname: Heilmann
authors.forename: Martin
authors.initials: M
authors.lastname: Schorsch
authors.forename: Thomas
authors.initials: T
authors.lastname: Hahn
mesh_terms: D000022:Abortion, Spontaneous / Q000276:immunology / Q000517:prevention & control*; D000328:Adult; D017252:CD3 Complex / Q000276:immunology; D019002:CD56 Antigen / Q000276:immunology; D010064:Embryo Implantation / Q000276:immunology; D004624:Embryo Transfer; D005260:Female; D058851:GPI-Linked Proteins; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007694:Killer Cells, Natural / Q000276:immunology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D017452:Receptors, IgG / Q000276:immunology; D020554:Sperm Injections, Intracytoplasmic; D055815:Young Adult
chemical_list: D017252:CD3 Complex; D019002:CD56 Antigen; C428200:FCGR3B protein, human; D058851:GPI-Linked Proteins; D016756:Immunoglobulins, Intravenous; D017452:Receptors, IgG