IVF and Immunology
Adapted from “The role of immunotherapy in In Vitro Fertilization: a guideline” (Fertility and Sterility 2018;110:387–400. 2018 by American Society for Reproductive Medicine).
In an effort to improve outcomes of In Vitro Fertilization in general, and in patients with recurrent implantation failure and/or pregnancy loss, adjuvant immunotherapies have been introduced into IVF treatment cycles. The rationale behind the use of these therapies is that they may correct an immunological imbalance resulting in improved and sustained implantation of the developing embryo, ultimately leading to improved live-birth outcome.
Unfortunately, many of the immunotherapies lack robust evidence from well-designed controlled trials to support their use. The reviewed immunotherapies are either not associated with improved live-birth outcome in IVF or have been insufficiently studied.
There is good evidence to recommend against the routine use of low-dose aspirin to improve the outcome of live birth in IVF.
There is good evidence to recommend against the routine use of corticosteroids to improve the outcome of live birth in IVF.
There is insufficient evidence to recommend Intravenous Immunoglobulin (IVIG) administration as part of IVF to improve IVF outcomes.
There is insufficient evidence to recommend intrauterine infusion of autologous peripheral mononuclear cells prior to embryo transfer to improve IVF outcome.
There is insufficient evidence to recommend immunosuppressive drugs treatment to improve IVF outcome.
Immunotherapies are either not associated with improved live-birth outcome in IVF or have been insufficiently studied to make definitive conclusions regarding benefits and risks.
There is no evidence to suggest screening for immunological conditions in an asymptomatic population considering IVF treatment.
Immunotherapies aimed at improving the likelihood of live birth in IVF treatment have largely proven to be ineffective or have been insufficiently investigated to make definitive recommendations for their use.