Pregnancy Outcome After Intralipid Infusion Among Women Experiencing Recurrent Pregnancy Loss

Abstract

Objective: We have previously reported that Intralipid suppresses natural killer (NK) cell cytotoxicity both in vitro and in vivo. The current study was undertaken to determine whether Intralipid treatment is associated with increased live birth rates. Methods: 79 patients with elevated NK-cell activity and a history of recurrent pre- or post-implantation pregnancy loss were treated with IV Intralipid, 2-4 mL of 20% solution. Of the 79 women, 68 had a diagnosis of recurrent implantation failure and 11 experienced recurrent pregnancy loss. Recurrent implantation failure was defined in this study as a cumulative total of 8 cleaved embryos transfered or 4 blastocysts transfered with human chorionic gonadotropin (hCG) serum concentrations <5 mIU/mL 14 days after embryo transfer. Recurrent pregnancy loss consisted of at least 2 or more consecutive spontaneous abortions. Results: Among the 68 women with a history of recurrent implantation failure, 27 (40%) became pregnant after in vitro fertilization and embryo transfer with intralipid treatment. Four of the 68 patients were over the age of 40 years and none of these became pregnant. Of 64 women under the age of 40 years who were experiencing recurrent implantation failure with elevated NK-cell activity, the pregnancy rate per cycle was 42%. Ten of the 11 women experiencing recurrent pregnancy loss (91%) had a successful pregnancy. Conclusions: Intralipid is effective in enhancing live birth rates among women with elevated NK-cell cytotoxicity and a history of recurrent implantation failure and recurrent pregnancy loss.