Intravenous Immunoglobulin Treatment Increased Live Birth Rate in a Spanish Cohort of Women with Recurrent Reproductive Failure and Expanded CD56+ Cells
Manuela Moraru
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Department of Immunology, Hospital Univesitario Puerta de Hierro Majadahonda, Madrid, Spain
Search for more papers by this authorJavier Carbone
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorDiana Alecsandru
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorMarcela Castillo-Rama
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorJuana Gil
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorBárbara Alonso
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorAngel Aguarón
Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorRocío Ramos-Medina
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorDesamparados Oliver-Miñarro
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorMargarita Rodríguez-Mahou
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorVirginia Ortega
Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorElena Meliá
Unidad de la Mujer, Hospital Ruber Internacional, Madrid, Spain
Search for more papers by this authorJuan Vidal
Unidad de la Mujer, Hospital Ruber Internacional, Madrid, Spain
Search for more papers by this authorMalena Cianchetta-Sivori
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorCarmen Esteban
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorLoreto Vargas-Henny
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorJonathan Dale
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorLuis Ortiz-Quintana
Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorEduardo Fernández-Cruz
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorCorresponding Author
Silvia Sánchez-Ramón
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Correspondence
Silvia Sánchez-Ramón, Division of Clinical Immunology, Department of Immunology, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain.
E-mail: [email protected]
Search for more papers by this authorManuela Moraru
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Department of Immunology, Hospital Univesitario Puerta de Hierro Majadahonda, Madrid, Spain
Search for more papers by this authorJavier Carbone
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorDiana Alecsandru
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorMarcela Castillo-Rama
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorJuana Gil
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorBárbara Alonso
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorAngel Aguarón
Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorRocío Ramos-Medina
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorDesamparados Oliver-Miñarro
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorMargarita Rodríguez-Mahou
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorVirginia Ortega
Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorElena Meliá
Unidad de la Mujer, Hospital Ruber Internacional, Madrid, Spain
Search for more papers by this authorJuan Vidal
Unidad de la Mujer, Hospital Ruber Internacional, Madrid, Spain
Search for more papers by this authorMalena Cianchetta-Sivori
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorCarmen Esteban
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorLoreto Vargas-Henny
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorJonathan Dale
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorLuis Ortiz-Quintana
Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorEduardo Fernández-Cruz
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Search for more papers by this authorCorresponding Author
Silvia Sánchez-Ramón
Clinical Immunology Unit, Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Correspondence
Silvia Sánchez-Ramón, Division of Clinical Immunology, Department of Immunology, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain.
E-mail: [email protected]
Search for more papers by this authorAbstract
Problem
Natural killer (NK, CD3− CD56+/CD16+) and NKT-like cells (CD3+ CD56+/CD16+) activity is considered among the key factors for reproductive success. In the absence of immunological screening, beneficial effects of intravenous immunoglobulin (IVIG) in preventing recurrent reproductive failure (RRF) have not been reported. Here, we analyse the IVIG influence on pregnancy success in women with RRF and circulating NK or/and NKT-like cells expansion.
Method of study
One hundred fifty-seven women with previous recurrent miscarriage and/or recurrent implantation failure after in vitro fertilization were consecutively studied. Sixty-four patients with CD56+ cell expansion, no apparent underlying disease and who maintained their desire to conceive were selected. Forty of them received IVIG during pregnancy.
Results
Overall, the clinical pregnancy rate for the women under IVIG therapy was 92.5% and the live birth rate was 82.5%. Significantly lower pregnancy and live birth rates (25% and 12.5%, respectively) were observed for the patients with recurrent pregnancy loss and NK/NKT-like cells expansion without IVIG. After three cycles of IVIG, NK cell percentages decreased significantly and these values persisted throughout gestation.
Conclusion
Intravenous immunoglobulin therapy for women with RRF and NK or NKT-like cell expansion was a safe and beneficial therapeutic strategy that associated with high clinical pregnancy and live birth rates.
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