title: Intravenous immunoglobulin treatment increased live birth rate in a Spanish cohort of women with recurrent reproductive failure and expanded CD56(+) cells.
abstract: OBJECTIVE
  Natural killer (NK, CD3(-)CD56(+)/CD16(+)) and NKT-like cells (CD3(+)CD56(+)/CD16(+)) activity is considered among the key factors for reproductive success. In the absence of immunological screening, beneficial effects of intravenous immunoglobulin (IVIG) in preventing recurrent reproductive failure (RRF) have not been reported. Here, we analyse the IVIG influence on pregnancy success in women with RRF and circulating NK or/and NKT-like cells expansion.
  
  
  METHODS
  One hundred fifty-seven women with previous recurrent miscarriage and/or recurrent implantation failure after in vitro fertilization were consecutively studied. Sixty-four patients with CD56(+) cell expansion, no apparent underlying disease and who maintained their desire to conceive were selected. Forty of them received IVIG during pregnancy.
  
  
  RESULTS
  Overall, the clinical pregnancy rate for the women under IVIG therapy was 92.5% and the live birth rate was 82.5%. Significantly lower pregnancy and live birth rates (25% and 12.5%, respectively) were observed for the patients with recurrent pregnancy loss and NK/NKT-like cells expansion without IVIG. After three cycles of IVIG, NK cell percentages decreased significantly and these values persisted throughout gestation.
  
  
  CONCLUSIONS
  Intravenous immunoglobulin therapy for women with RRF and NK or NKT-like cell expansion was a safe and beneficial therapeutic strategy that associated with high clinical pregnancy and live birth rates.
authors.affiliation: Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Manuela
authors.initials: M
authors.lastname: Moraru
authors.forename: Javier
authors.initials: J
authors.lastname: Carbone
authors.forename: Diana
authors.initials: D
authors.lastname: Alecsandru
authors.forename: Marcela
authors.initials: M
authors.lastname: Castillo-Rama
authors.forename: Aurea
authors.initials: A
authors.lastname: García-Segovia
authors.forename: Juana
authors.initials: J
authors.lastname: Gil
authors.forename: Bárbara
authors.initials: B
authors.lastname: Alonso
authors.forename: Angel
authors.initials: A
authors.lastname: Aguarón
authors.forename: Rocío
authors.initials: R
authors.lastname: Ramos-Medina
authors.forename: Juan
authors.initials: J
authors.lastname: Martínez de María
authors.forename: Desamparados
authors.initials: D
authors.lastname: Oliver-Miñarro
authors.forename: Margarita
authors.initials: M
authors.lastname: Rodríguez-Mahou
authors.forename: Virginia
authors.initials: V
authors.lastname: Ortega
authors.forename: Pedro
authors.initials: P
authors.lastname: Caballero
authors.forename: Elena
authors.initials: E
authors.lastname: Meliá
authors.forename: Juan
authors.initials: J
authors.lastname: Vidal
authors.forename: Malena
authors.initials: M
authors.lastname: Cianchetta-Sivori
authors.forename: Carmen
authors.initials: C
authors.lastname: Esteban
authors.forename: Loreto
authors.initials: L
authors.lastname: Vargas-Henny
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dale
authors.forename: Luis
authors.initials: L
authors.lastname: Ortiz-Quintana
authors.forename: Eduardo
authors.initials: E
authors.lastname: Fernández-Cruz
authors.forename: Silvia
authors.initials: S
authors.lastname: Sánchez-Ramón
mesh_terms: D000026:Abortion, Habitual / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D000328:Adult; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007155:Immunologic Factors / Q000008:administration & dosage*; D007694:Killer Cells, Natural / Q000276:immunology* / Q000378:metabolism; D050498:Live Birth; D018655:Lymphocyte Count; D055611:Natural Killer T-Cells / Q000276:immunology* / Q000378:metabolism; D011247:Pregnancy; D012189:Retrospective Studies; D013030:Spain
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors