Degree of TNF-α/IL-10 Cytokine Elevation Correlates With IVF Success Rates in Women Undergoing Treatment With Adalimumab (Humira) and IVIG

Abstract

The degree of preconception TNF/IL-10 elevation may correlate with an increased risk of IVF failure. Elevated TNF-α/IL-10 ratios can be corrected with therapy. It may be possible to improve IVF success rates by modulating high cytokine levels. Although our pilot database is small, the trends in the data are consistent and compelling. Larger studies are needed for confirmation.

The Power of Observation

“…1,4 Increased TNF-a and Th1 ⁄ Th2 as well as reduced Treg activity has been linked to recurrent unexplained miscarriages and to IVF failure. 1 Could presence of anti-TNF-a at the time of implantation have reduced success rates? Treatment given during the time of antral follicle development appeared to generate significantly higher success rates than treatment at later times.…”

“…An important aspect in the Winger et al 1 paper is reporting the live birth rate per embryo (LBR ⁄ E), as well as per woman (cycle). As previously explained, if 50% of oocytes are abnormal, and for that reason will not generate embryos that can implant and gestate to term, a 46% LBR ⁄ E reported for those with complete Th1 ⁄ Th2 ratio correction would be very close to 100% success for normal embryos.…”

First-trimester maternal cell microRNA is a superior pregnancy marker to immunological testing for predicting adverse pregnancy outcome

“…Such cases have often been associated with abnormalities in several different in vitro immune parameters: natural killer cell cytotoxicity, proportion of peripheral blood CD56+CD3− cells, and Th1:Th2 bias. When patients with these abnormalities are treated with immunotherapy, results have been encouraging (Carp, 2007;Clark et al, 2006;Winger et al, 2011aWinger et al, , 2011b. However, the immunological assays employed have low specificity and sensitivity (Lee et al, 2013;Thum et al, 2004).…”

Recurrent spontaneous abortions, Hashimoto thyroiditis and alopecia totalis: response to anticoagulation and intravenous immunoglobulin therapy

“…Bearing in mind that AA is a T-cell, and probable NK cell, mediated autoimmune disease, it could be possible that IVIg therapy had a beneficial effect on our patient's scalp hair growth [28]. Actually, the response to IVIg therapy in our case could be a consequence of the favourable effect of IVIg on tumor necrosis factor alpha (TNFa) levels, as elevated TNF-a levels were associated with both AA and RSA [29,30].…”