With IVF success rates improving all the time, the majority of patients will be pregnant within three cycles of treatment, but it is the few that are not, that are the most concerning for Bourn Hall Clinic consultant Dr Valentina Mauro. Valentina is encouraged by results from the first few women at Bourn Hall Clinic to use an immunotherapy treatment using Intralipids.
“It can be heartbreaking when I see women below the age of 37 with good quality eggs who have been unable to achieve or sustain a pregnancy without any clear explanation.
“It is thought that a possible cause for repeated IVF failure is that the pregnancy is being rejected by the body’s immune system so we have been investigating how this can be overcome.”
The immune system is designed to protect you from disease and so it fights off invading cells that are different from your own. Usually the immune system is directed against harmful bacteria and viruses; however it can also reject an embryo.
An embryo carries genetic information from two different people which makes it ‘foreign’ to the body. Under normal circumstances a woman’s immune system recognises that the pregnancy poses no harm to the body.
One type of cell that fights disease in your body is the “natural killer cell’ or NK cells. It is thought that in most pregnant women the action of NK cells is suppressed so that the baby is carried to full term, and that the cells may play a role in creating a healthy blood supply to the baby.
However, it is possible that for some women this mechanism isn’t turned off and the NK cells try and reject the embryo.
Valentina has been studying this subject for several years and is determined to help women affected by this process. Bourn Hall Clinic has started to offer an immunotherapy treatment to patients who have been repeatedly unable to achieve a pregnancy through IVF. The therapy uses ‘Intralipids’ which act to suppress the NK cells.
Intralipids for repeated IVF failure
Intralipids are derived mainly from soya protein and eggs and are administered using a drip. They are more commonly used as a nutritional supplement for patients in hospital who are very ill and cannot feed themselves. They have been used without problems for many years and have a proven safety record.
Valentina explains; “It is very early days, but the first five women at Bourn Hall Clinic treated with Intralipids all became pregnant.
“Sadly one lady later miscarried; but prior to having immunotherapy, none of these women had achieved a pregnancy despite several cycles of IVF.
“As a result we are now offering Intralipids treatment to more women and hope in doing so to develop an evidence-base for when the treatment might be helpful.
“Ideally we would like to be able to predict which patients would benefit from Intralipids before they experience unsuccessful cycles of IVF.
It takes 60-90 minutes for the Intralipids to be administered intravenously and this is performed four to seven days before embryo transfer. Valentina is also recommending that it is re-administered four to five weeks following a positive pregnancy test. Patients wanting to use it must not have allergies to soya or eggs.
Although it’s early days, Valentina is quietly confident about the treatment:
“It is wonderful to be able to offer some hope to this small group of patients. The first results are promising but we are still holding our breath.”