title: Intralipid therapy for recurrent implantation failure: new hope or false dawn?
abstract: Recurrent embryo implantation failure (RIF) is a disorder with potentially devastating physiological and psychological manifestations for those affected. Although its prevalence is not uncommon, many of the mechanisms involved still require elucidation. Both organ-specific and systemic autoimmunity are associated with an increased prevalence of recurrent miscarriage and reproductive failure, rendering the role of the maternal immunological system in fertility a key concept. It is believed by some that central to this theme is the maternal cytokine profile, with particularly T-helper (Th) cells. Immune modulating therapies have therefore been mooted as potential therapeutic strategies. Recent reports of high pregnancy rates achievable in women with RIF have added fuel to the debate regarding the effectiveness of intralipid in modulating the immune system. We would like to assess if there is sufficient current evidence of acceptable quality to permit an assumption that intralipid therapy is an effective treatment for women undergoing repeated assisted reproduction cycles. We have concluded that appropriately controlled, large-scale, confirmatory studies are necessary to prove the efficacy of intralipid before it can be recommended for routine use.
authors.affiliation: School of Biomedical Sciences, King's College London, Guy's Campus, London SE1 1UL, UK. ns605@soton.ac.uk
authors.forename: N
authors.initials: N
authors.lastname: Shreeve
authors.forename: K
authors.initials: K
authors.lastname: Sadek
mesh_terms: D000026:Abortion, Habitual / Q000276:immunology / Q000628:therapy*; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015551:Autoimmunity; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000276:immunology; D004195:Disease Models, Animal; D004655:Emulsions / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D056747:Immunomodulation; D007167:Immunotherapy / Q000379:methods*; D010743:Phospholipids / Q000627:therapeutic use*; D013024:Soybean Oil / Q000627:therapeutic use*; D018417:Th1 Cells / Q000276:immunology*; D058408:Th1-Th2 Balance
chemical_list: D000893:Anti-Inflammatory Agents; D016207:Cytokines; D004655:Emulsions; D010743:Phospholipids; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil