title: Immunomodulatory treatment with intravenous immunoglobulin and prednisone in patients with recurrent miscarriage and implantation failure after in vitro fertilization/intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To assess outcome in terms of live-birth rate after fresh or frozen IVF/intracytoplasmic sperm injection assisted reproductive technology (ART) cycles where immunomodulation was given to patients with recurrent pregnancy loss after prior ART treatments.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  Fifty-two patients with a history of at least three consecutive pregnancy losses after ART who underwent at least one further ART cycle with concurrent immunomodulation in 2003-2012.
  
  
  METHODS
  Immunomodulation with IV immunoglobulin and prednisone starting from before ET and continuing in the first trimester if pregnancy was established.
  
  
  METHODS
  Live-birth rate per ET and cumulative live-birth rate after up to five ETs.
  
  
  RESULTS
  Nineteen patients (36.5%) achieved a live birth after the first ET with immunomodulation, and a total of 32 patients achieved a live birth in the study period, resulting in a cumulative live-birth rate of 61.5%. There was no significant difference in baseline and immunological parameters between the patients achieving a live birth or not. The live-birth rate after the first immunomodulated ART cycle in our patients is higher than that reported in a previous study.
  
  
  CONCLUSIONS
  Immunomodulation with a combination of IV immunoglobulin and prednisone is a promising treatment for recurrent pregnancy loss after ART, but randomized placebo-controlled trials are needed.
authors.affiliation: Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, København, Denmark. Electronic address: nyborg@dadlnet.dk.
authors.forename: Kathinka Marie
authors.initials: KM
authors.lastname: Nyborg
authors.affiliation: Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, København, Denmark.
authors.forename: Astrid Marie
authors.initials: AM
authors.lastname: Kolte
authors.affiliation: Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, København, Denmark.
authors.forename: Elisabeth Clare
authors.initials: EC
authors.lastname: Larsen
authors.affiliation: Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, University Hospital Copenhagen, Rigshospitalet, København, Denmark; Department of Obstetrics and Gynecology, Aalborg University Hospital, Reberbansgade, Aalborg, Denmark.
authors.forename: Ole Bjarne
authors.initials: OB
authors.lastname: Christiansen
mesh_terms: D000026:Abortion, Habitual / Q000628:therapy*; D000328:Adult; D001723:Birth Rate; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D056747:Immunomodulation / Q000276:immunology*; D007246:Infertility / Q000276:immunology*; D011241:Prednisone / Q000008:administration & dosage*; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D016756:Immunoglobulins, Intravenous; D011241:Prednisone
keywords: ART; IVF/ICSI; IVIg; Recurrent miscarriage; recurrent implantation failure