Intralipids or Immunglobulin therapy for spontaneous pregnancy loss
Which is better for pregnancy?
Spontaneous pregnancy loss (more commonly called abortion) occurs most often during the first trimester of pregnancy. This is biologically because during this period, most developmental changes in the foetus occur, the placenta develops and the mother’s body must adapt to the physiology of pregnancy. Many women unfortunately experience abortion, but the next pregnancy goes to term, rendering it a simple bad memory. However, some people are affected by repetitive abortion (defined as at least three), and this can become a pathology.
There are so many ways that a pregnancy can interrupt that a cure is difficult. However, in some cases, the cause appears to be immunological (i.e. the body recognises the foetus as ‘foreign’ and attacks it).
Where this is true, the best therapy is one designed to buffer the immunological response.
Usually, patients take a therapy of aspirin, cortisone, even Viagra has been known to be adminstered to try to help patients bypass the critical period. These therapies usually have some immune response buffering effect, but also try to increase blood flow to the uterus, prevent blood clots forming etc. Therapies designed specifically to try to buffer the immune response to the pregnancy are currently known as intravenous immunoglobulin therapy (IVIG) and intralipids.
IVIG therapy uses the infusion of immunoglobulins purified from human blood. The idea is that the extra antibodies from foreign blood dampens the immune response to foreign antigens (a foetus is an example). Yes, it’s immunosuppression. This is easy to understand – add antibodies and hope to suppress the immune response.
Intralipids are a fat emulsion purified from Soya beans. The mixture is traditionally used with anaesthetics to prevent local anaesthetic overdose and cytotoxicity. The mixture is also administered to patients unable to feed themselves. So how did intralipids make the transition to immunotherapy for in vitro fertilisation? The earliest mention of intralipid therapy for recurrent abortion we found in a literature search was by Clark, D., 1994. How the therapy made the formal transition into in vitro fertilisation is not apparrently attributed to anyone (apologies if this is not true – please enlighten us!).
What are the differences between intralipids and immunoglobulin therapy?
|Source||Purified from blood||Purified from Soya|
|Safety||Can cause drastic side effects||Safe unless patient is allergic to Soya or eggs|
|Action||Suppressor of NK cellsSuppresses autoantibody productionEnhances regulatory T-cell activity||Buffers IgM, IgG and IgA productionBuffers immune cell proliferation|
|Cost||Approx $2000/dose||Approx $100/dose|
|Sources||Salo, M. 1990
Roussey et al., 2007
Since the work by Roussey et al., 2007 showed very similar immune buffering effects for both IVIG and intralipids, we predict that intralipid therapy, for its safety, cost and effectiveness willl eventually become the therapy of choice.
Search for an IVF specialist offering intralipid therapy in your area: