Current Trends of Reproductive Immunology Practices in <i>In Vitro</i> fertilization (<scp>IVF</scp>) ‐ A First World Survey Using <scp>IVF</scp>‐Worldwide.com

Kwak‐Kim, Joanne; Han, Ae Ra; Gilman‐Sachs, Alice; Fishel, Simon; Leong, Milton; Shoham, Zeev

doi:10.1111/j.1600-0897.2012.01183.x

Cited by 38 publications

(41 citation statements)

References 32 publications

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“…Where the TH1/TH2 intracellular cytokine ratio was disturbed (n = 50), Intralipid® 20% (Fresenius Kabi, New Zealand) was administered (Kwak–Kim et al, 2013). …”

Section: Methodsmentioning

confidence: 99%

Precision Medicine in Assisted Conception: A Multicenter Observational Treatment Cohort Study of the Annexin A5 M2 Haplotype as a Biomarker for Antithrombotic Treatment to Improve Pregnancy Outcome

Fishel¹,

Baker²,

Elson³

et al. 2016

eBioMedicine

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BackgroundPregnancy failure and placenta mediated pregnancy complications affect > 25% of pregnancies. Although there is biological plausibility for a procoagulant mechanism underlying some of these events, antithrombotic intervention trials demonstrate limited benefit, possibly through lack of stratification in heterogeneous patient groups. The ANXA5 M2 haplotype is a possible procoagulant biomarker and was tested pragmatically to determine whether this screening and LMWH treatment normalized the outcome for ANXA5 M2 positive couples.This was a pragmatic study that aimed to measure the effectiveness of a testing (for the M2 haplotype) and treatment (LMWH) pathway in routine clinical practice where there is variation between patients. Such a study in couples with fertility problems can inform choices between treatments; it is then the management protocol which is the subject of the investigation, not the individual treatments.MethodsCouples (N = 77) with one or both partners ANXA5 M2 positive demonstrated association of this haplotype with adverse IVF outcome. A pragmatic, multicenter, prospective cohort study of ANXA5 M2 haplotype screening, and LWMH treatment following embryo transfer (ET) in 103 IVF couples positive for ANXA5 M2 was performed. They were compared with a group of 1000 contemporaneous randomly selected unscreened and untreated couples undergoing assisted conception, from which 103 matched control couples were derived. The primary outcome measure was live birth incidence. Secondary outcomes were results following embryo transfer (ET) and live birth outcome by gender and M2 carriage, and allelic dose influence.FindingsThe tested and treated cohort of ANXA5 M2 carriers achieved a similar live birth rate (37.9%) per ET cycle compared to both the more fertile comparison group (38.5%), and to the 103 matched controls (33.0%). Significantly more treated male carrier only couples had a live birth versus female M2 only (47.7% vs. 25.0% p = 0.045).InterpretationPragmatic ANXA5 M5 screening and treatment with LMWH in couples undergoing IVF is associated with similar outcome to couples with more favorable prognostic factors. The difference in live birth outcome for treated male only carrier couples may be consistent with an additional maternal thrombophilic factor that may adversely affect pregnancy, although other mechanisms are possible. This study suggests that LMWH treatment should be started prior to clinical pregnancy.

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“…Where the TH1/TH2 intracellular cytokine ratio was disturbed (n = 50), Intralipid® 20% (Fresenius Kabi, New Zealand) was administered (Kwak–Kim et al, 2013). …”

Section: Methodsmentioning

confidence: 99%

Precision Medicine in Assisted Conception: A Multicenter Observational Treatment Cohort Study of the Annexin A5 M2 Haplotype as a Biomarker for Antithrombotic Treatment to Improve Pregnancy Outcome

Fishel¹,

Baker²,

Elson³

et al. 2016

eBioMedicine

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“…1 This value is less than that reported in the literature, 2 suggesting that either IVF physicians recognize immunologic problems less often their actual frequency as a result of lack of reproductive immunology resources or incomplete evaluation or the prevalences reported in the literature reflect the 'if all you have is a hammer, everything looks like a nail' phenomenon. 1 This value is less than that reported in the literature, 2 suggesting that either IVF physicians recognize immunologic problems less often their actual frequency as a result of lack of reproductive immunology resources or incomplete evaluation or the prevalences reported in the literature reflect the 'if all you have is a hammer, everything looks like a nail' phenomenon.…”

mentioning

confidence: 90%

“…1 The aim of the webbased survey was to investigate the awareness of physicians performing IVF to the importance of immunologic alteration and reproductive outcome. 1 The aim of the webbased survey was to investigate the awareness of physicians performing IVF to the importance of immunologic alteration and reproductive outcome.…”

mentioning

confidence: 99%

“…1 Caution should be taken when interpreting these results as the figures reflect the views of individuals answering the questionnaire which could introduce a bias. 1 Caution should be taken when interpreting these results as the figures reflect the views of individuals answering the questionnaire which could introduce a bias.…”

mentioning

confidence: 99%

“…4 Large associations (>4) are more likely to be attributable to causality than are weak associations as weak associations are more likely attributable to bias (selection, information and confounding bias). 1 Implantation remains the rate-limiting step towards the success of IVF treatment. The association of specific thrombophilic gene mutations with the various types of reproductive problems has been controversial, [5][6][7][8] and the studies that show significant associations (P < 0.05) in patients with IVF failure have RR < 3 and OD < 4.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Commentary on Current Trends of Reproductive Immunology Practices in IVF: A first world survey using IVF‐worldwide.com

Coulam

2012

American J Rep Immunol

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Recurrent Pregnancy Loss: Definitions, Epidemiology, and Prognosis

Bashiri

Borick

2016

Recurrent Pregnancy Loss

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Current Trends of Reproductive Immunology Practices in In Vitro fertilization (IVF) ‐ A First World Survey Using IVF‐Worldwide.com

Abstract: Reproductive immunology principles have been applied to the clinical management of RPL, RIF, and failed IVF cycles, and a significant proportion of IVF physicians acknowledge the importance of immunologic alterations with reproductive outcomes.

Cited by 38 publications

References 32 publications

Precision Medicine in Assisted Conception: A Multicenter Observational Treatment Cohort Study of the Annexin A5 M2 Haplotype as a Biomarker for Antithrombotic Treatment to Improve Pregnancy Outcome

Precision Medicine in Assisted Conception: A Multicenter Observational Treatment Cohort Study of the Annexin A5 M2 Haplotype as a Biomarker for Antithrombotic Treatment to Improve Pregnancy Outcome

Commentary on Current Trends of Reproductive Immunology Practices in IVF: A first world survey using IVF‐worldwide.com

Recurrent Pregnancy Loss: Definitions, Epidemiology, and Prognosis

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