Elevated Preconception CD56+16+ and/or Th1:Th2 Levels Predict Benefit from IVIG Therapy in Subfertile Women Undergoing IVF

Abstract

In subfertile women with preconception Th1:Th2 and/or % CD56(+) cell elevation, IVF success rates are low without IVIG therapy but significantly improve with IVIG therapy. In patients with normal Th1:Th2 and normal CD56(+) cell levels, IVF success rates were not further improved with IVIG therapy. IVIG may be a useful treatment option for patients with previous IVF failure and preconception Th1:Th2 and/or NK elevation. Preconception immune testing may be a critical tool for determining which patients will benefit from IVIG therapy. Prospective controlled studies (preferably double-blind, stratified, and randomized) are needed for confirmation.

Sphingolipid Pathway Regulates Innate Immune Responses at the Fetomaternal Interface during Pregnancy

“…Immunoglobulin therapy has been shown to be clinically beneficial in some selected groups of women with RPL by reducing NK cell cytotoxicity or favorably decreasing Th1/Th2 ratios (52)(53)(54). Our preliminary data revealed that the immunoglobulin therapy was effective for decreasing pregnancy loss in Sphk1…”

First Trimester Pbmc Microrna Predicts Adverse Pregnancy Outcome

“…[21][22][23] In cases where an abnormality was present, IVIG was administered at least once during the IVF cycle or at a positive pregnancy test. An additional IVIG was given during the first trimester of pregnancy and then at 4 week intervals, if these levels were still elevated following repeated monthly% CD56 + cell and/or NK cytotoxicity assessment.…”

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).…”