SynthesisJournal of assisted reproduction and genetics2006
Is intravenous immunoglobulins (IVIG) efficacious in early pregnancy failure? A critical review and meta-analysis for patients who fail in vitro fertilization and embryo transfer (IVF).
Synthesis in Journal of assisted reproduction and genetics, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 95 citations in OpenAlex.
- Intralipid therapy and adverse reproductive outcome: is there any evidence?Reproduction & fertility · 2021Pooled it
- Phenotype- and phase-directed immune interpretation in recurrent implantation failure and pregnancy loss: an integrative framework.Frontiers in reproductive health · 2026Review
- Exploring the Immunological Aspects and Treatments of Recurrent Pregnancy Loss and Recurrent Implantation Failure.International journal of molecular sciences · 2025Review
- Live Birth Rate in Women with Recurrent Pregnancy Loss after In Vitro Fertilization with Concomitant Intravenous Immunoglobulin and Prednisone.Journal of clinical medicine · 2022Article
- Prenatal stress increases IgA coating of offspring microbiota and exacerbates necrotizing enterocolitis-like injury in a sex-dependent manner.Brain, behavior, and immunity · 2020Article
- Is there a Role of Intravenous Immunoglobulin in Immunologic Recurrent Pregnancy Loss?Journal of immunology research · 2020Review
- Immune modulation of i.v. immunoglobulin in women with reproductive failure.Reproductive medicine and biology · 2018Review
- ART implantation failure and miscarriage in patients with elevated intracellular cytokine ratios: response to immune support therapy.Fertility research and practice · 2018Article
- Pravastatin to prevent recurrent fetal death in massive perivillous fibrin deposition of the placenta (MPFD).The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2016Article
- Successful Pregnancy Outcome in Women with Recurrent IVF Failure and Anti-hCG Autoimmunity: A Report of Three Cases.Case reports in immunology · 2016Article
- Evaluation of CD56(dim) and CD56(bright) natural killer cells in peripheral blood of women with IVF failures.Iranian journal of reproductive medicine · 2015Article
- The advantage of specific intravenous immunoglobulin (sIVIG) on regular IVIG: experience of the last decade.Journal of clinical immunology · 2013Review
- Evidence for the use of intravenous immunoglobulins--a review of the literature.Clinical reviews in allergy & immunology · 2010Review
- [Intravenous immunoglobulins in multiple sclerosis. An update].Der Nervenarzt · 2009Review
- Clinical experience with intravenous immunoglobulin and tnf-a inhibitor therapies for recurrent pregnancy loss.The Ulster medical journal · 2009Article
- Expression of NKp46 and other activating inhibitory receptors on uterine endometrial NK cells in females with various reproductive failures: A review.Reproductive medicine and biologyReview
- CD200-dependent and nonCD200-dependent pathways of NK cell suppression by human IVIG.Journal of assisted reproduction and geneticsArticle
Corrections and comments
- Erratum issued
Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
problemIntravenous Immunoglobulins (IVIG) are widely used off label in the treatment of early reproductive failure. As IVIG is expensive, and may have side-effects, evidence of efficacy is needed. Previous results have suggested that the pre-conception treatment of primary recurrent abortion patients might be effective, but the data set has been too small for adequate statistical power. More recently it has been suggested that IVIG may improve the success rate of in vitro fertilization and embryo transfer (IVF) in patients with prior IVF failures, but clinical trials have given conflicting results that need explanation. Systematic reviews generating inconclusive results have focused on methodological rigor to the exclusion of biological plausibility.
methodsReview of current basic science of design, measurement, and evaluation of clinical trials and basic science mechanisms providing a rationale for treatment. Meta-analysis of published randomized controlled and cohort-controlled trials (updated with two unpublished data sets) evaluating IVIG treatment in IVF failure patients. Live birth rate was used as the most relevant endpoint. The ability of different sources of IVIG to suppress natural killer (NK) cell activity was determined using a standard (51)Cr-release assay in vitro. RESULTS AND
conclusionsMeta-analysis of three published randomized controlled trials (RCTs) of IVIG in IVF failure patients shows a significant increase in the live birth rate per woman (p = 0.012; Number Needed to Treat for 1 additional live birth, NNT = 6.0 women). Using live birth rate per embryo transferred, and adding data from two cohort-controlled trials to the meta-analysis further supports this conclusion (overall p = 0.000015, NNT = 3.7 women). Relevant variables appear to include properties and scheduling of the IVIG, and selection of patients with abnormal immune test results. Different IVIG preparations vary significantly in their ability to suppress NK activity in vitro. A rationale for use of IVIG is provided by a review of mechanisms of IVIG action and mechanisms underlying failure of chromosomally normal embryos.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.