The Immunotherapy during in vitro Fertilization and Embryo Transfer Cycles in Infertile Patients with Endometriosis
- 1 October 1997
- journal article
- clinical trial
- Published by Wiley in Journal of Obstetrics and Gynaecology Research
- Vol. 23 (5), 463-470
- https://doi.org/10.1111/j.1447-0756.1997.tb00874.x
Abstract
To investigate if the immunotherapy with corticosteroids would improve the pregnancy rate in infertile patients with endometriosis who undergo in vitro fertilization and embryo transfer (IVF-ET). Forty-two infertile patients with endometriosis plus tubal factor and 87 pure tubal infertility patients who underwent IVF-ET in our unit were allocated randomly to the corticosteroid treatment group and the control group. The prevalence of autoantibodies (antinuclear antibody, lupus anticoagulant, anticardiolipin antibody, rheumatoid factor) was elevated significantly in patients with endometriosis plus tubal factor compared with pure tubal infertility patients (38.1% vs 2.3%). Twenty-one patients with endometriosis plus tubal factor underwent 54 cycles of IVF-ET, receiving corticosteroids. Forty-three patients with pure tubal factor underwent 81 cycles of IVF-ET, receiving corticosteroids. Twenty-one patients with endometriosis plus tubal factor who underwent 57 cycles of IVF-ET and 44 patients with pure tubal factor who underwent 84 cycles of IVF-ET served as controls, not receiving corticosteroids. In patients with endometriosis plus tubal factor, there was a significantly higher clinical pregnancy rate per cycle in the treatment group, with 42.6% (23/54) compared with 22.8% (13/57) in the control group but no differences between 2 groups in spontaneous abortion rate (21.7% vs 15.4%) and multiple pregnancy rate (17.4% vs 15.4%). In patients with pure tubal infertility, there were no significant differences between the treatment group and control group in clinical pregnancy rate (40.7% vs 34.5%), spontaneous abortion rate (12.1% vs 10.3%) or multiple pregnancy rate (18.2% vs 10.3%). In the endometriosis plus tubal infertility group with autoantibodies, the clinical pregnancy rate per cycle was significantly higher in the treatment group at 40.9% compared with 14.8% in the control group. In endometriosis plus tubal infertility group without autoantibodies, there was no significant difference between 2 groups with respect to the clinical pregnancy rate per cycle (43.8% vs 30.0%). This study suggests that immunotherapy with corticosteroids could improve the clinical pregnancy rate in endometriosis patients undergoing IVF-ET and may be more effective in patients with positive autoantibodies.Keywords
This publication has 24 references indexed in Scilit:
- Autoreactivity in women with endometriosisBJOG: An International Journal of Obstetrics and Gynaecology, 1991
- Intravenous Gamma-Globulin In PregnancyObstetrical & Gynecological Survey, 1989
- In vitro fertilization and embryo transfer (IVF/ET): An established and successful therapy for endometriosisJournal of Assisted Reproduction and Genetics, 1988
- Altered maturation and function of peritoneal macrophages: Possible role in pathogenesis of endometriosisAmerican Journal of Obstetrics and Gynecology, 1987
- ENDOMETRIOSIS AND IN-VITRO FERTILISATIONThe Lancet, 1985
- IN-VITRO FERTILISATION FOR ENDOMETRIOSISThe Lancet, 1985
- ENDOMETRIOSIS AND OVULATORY DISORDER: REDUCED FERTILISATION IN VITRO COMPARED WITH TUBAL AND UNEXPLAINED INFERTILITYThe Lancet, 1985
- Immunologic Aspects of Human EndometriosisAmerican Journal of Reproductive Immunology, 1984
- Accentuated cyclic activation of peritoneal macrophages in patients with endometriosisAmerican Journal of Obstetrics and Gynecology, 1984
- ENDOMETRIOSISClinical Obstetrics and Gynecology, 1980