Live Birth Rates after Active Immunization with Partner Lymphocytes

Abstract

Although many potential causes have been established for recurrent implantation failure (RIF) and recurrent miscarriage (RM), about 50% of these remain idiopathic. Scientific research is focused on immunological risk factors. In the present study, we aim to evaluate live birth rates after immunization with paternal lymphocytes (lymphocyte immunotherapy (LIT)). This retrospective study consisted of 148 couples with a history of RM and/or RIF. The women underwent immunization with lymphocytes of their respective partners from November 2017 to August 2019. Fifty-five patients (43%) had live births. Stratified by indication (RM, RIF, combined), live birth rates in the RM and the combined group were significantly higher than that in the RIF group (53%, 59% and 33%, respectively, p = 0.02). The difference was especially noticeable during the first 90 days after immunization (conception rate leading to live births: 31%, 23% and 8% for RM, the combined group and RIF, respectively; p = 0.005), while there was no difference between groups during the later follow-up. LIT was associated with high live birth rates, especially in women with recurrent miscarriage. In view of the limited data from randomized studies, LIT cannot be recommended as routine therapy. However, it may be considered in individual cases.

Adverse drug reactions following lymphocyte immunotherapy for the treatment of infertility: A retrospective study

“…Unfortunately, we did not have the information about the number of pregnancy attempts and embryo transfers before and after LIT, mainly because patients were assigned by many fertility centers from all over Germany. In future studies this information needs to be taken into account, especially since it was shown that LIT is more successful in patients with a history of recurrent miscarriages than with recurrent implantation failure 48 . This study was neither randomized nor controlled.…”

“…The birth rate was 38% after IVF and 42% spontaneously. In a recently published study by Günther et al a live birth rate of 43% was found in 148 couples according to LIT 48 . Interestingly, the success was strongly dependent on the indication: the live birth rate was significantly higher in women with recurrent miscarriages (53%) in contrast to women with recurrent implantation failure (33%), especially in the first 90 days after LIT, which suggest that LIT appears to have a more pronounced effect on women with recurrent miscarriages.…”

“…In future studies this information needs to be taken into account, especially since it was shown that LIT is more successful in patients with a history of recurrent miscarriages than with recurrent implantation failure. 48 This study was neither randomized nor controlled. There was no placebo or control group.…”

“…In 2019, around 62 000 women in Germany received IVF treatment. 47 Live births per embryo transfer were 48 Interestingly, the success was strongly dependent on the indication: the live birth rate was significantly higher in women with recurrent miscarriages (53%) in contrast to women with recurrent implantation failure (33%), especially in the first 90 days after LIT, which suggest that LIT appears to have a more pronounced effect on women with recurrent miscarriages. Despite these observations, the success of LIT in reproductive medicine is controversial: A first metaanalysis could not find any improvement in the live birth rate.…”

MTR, MTRR and CBS gene polymorphisms in recurrent miscarriages: A case control study from North India

“…[ 1 ] It is a multifactorial disorder where various abnormal conditions intertwine together making the phenotype adverse. Previous studies have reported that RM is caused by various factors like genetics, metabolic and hormonal disorders, lifestyle issues, thrombophilia, autoimmunity, uterine anomalies, antiphospholipid syndrome, infection and sperm quality,[ 2 3 4 5 ] but there are no definitive conclusions for the aetiology of 50% of the RM cases. [ 6 7 ]…”