Clinical and immunological criteria for the use of intravenous immunoglobulins in women with reproductive failures

Abstract

BACKGROUND:In obstetrics and reproductive medicine, the use of intravenous immunoglobulin remains controversial. There are no clearly developed indications for immunoglobulins therapy. The search for immunological criteria for prescribing this therapy is an urgent task AIM:The aim of this study was to evaluate the effectiveness of the use of intravenous immunoglobulins in the complex therapy of women with multiple reproductive losses associated with changes in the quantitative and functional parameters of natural killer cells. MATERIALS AND METHODS:Group 1 consisted of 61 women with recurrent miscarriage; group 2 involved 40 women with two or morein vitrofertilization failures, while group 3 comprised 27 healthy fertile individuals. The activity of blood natural killer cells was assessed by CD107a expression before and after activation. Patients with altered natural killer cell activity received intravenous immunoglobulins therapy under the control of the dynamics of immunological parameters. RESULTS:The number of natural killer cells that expressed CD107a before and after activation differed between the study groups. In patients receiving intravenous immunoglobulins, gestational complications were observed less frequently, with the incidence of biochemical pregnancy being higher. CONCLUSIONS:In patients with early reproductive failures (such as recurrent miscarriage andin vitrofertilization failures) and immunological abnormalities in the form of altered Natural killer cell activity, the use of intravenous immunoglobulins has an immunomodulatory and clinical effect.