Intralipid Significantly Increases Pregnancy Rates After Implantation Failure With IVF/ICSI: Presented at ESHRE

By Chris Berrie

BARCELONA, Spain -- July 6, 2018 -- Intravenous intralipid is safe and significantly increases pregnancy rates compared with placebo in women with previous implantation failure after in vitro fertilisation/ intracytoplasmic sperm injection (IVF/ICSI), according to a study presented here at the 34th Annual Meeting of the European Society for Human Reproduction and Embryology (ESHRE).

“Implantation is the final step in the whole cascade of events of IVF and it is the most important rate-limiting factor,” said Neeta Singh, MD, All India Institute of Medical Sciences, New Delhi, India.

As implantation failure is becoming an increasing problem, attention needs to be paid not only to good embryos and receptive endometrium, but also to adequate maternal response. While the focus has generally been to optimise the first 2, the immunological challenge posed by the third remains to be approached more directly.

According to Dr. Singh, one way to improve implantation might be to better regulate the feto-maternal immune tolerance, which can lead to an inflammatory response and implantation failure when dysfunctional.

Intralipid is a synthetic, sterile fat emulsion containing 10% soybean oil, 1.2% egg yolk phospholipids, and 2.25% glycerine, and water.

For the current study, women with previous failed IVF undergoing IVF/ICSI from June 2016 to January 2018 were randomised to receive placebo (n = 52) or 2 doses of 20% IV intralipid 4 mL diluted in 100 mL normal saline by slow infusion (n = 53). The first dose was given immediately after oocyte recovery and the second dose given 1 hour prior to transfer.

The implantation rate for the intralipid group was 26.7% compared with 10.0% for the placebo group (P = .012). The clinical pregnancy rate was 36.6% and 14.0%, respectively (P = .023).

The ongoing pregnancy rate -- defined as pregnancy continuing beyond 16 weeks gestation -- was 34.6% and 14% in intervention and control groups, respectively (P = .016).

Multivariate logistic regression analysis showed that administration of intralipid was the strongest significant variable (adjusted odds ratio [aOR] = 10.78; P = .02), followed by day of embryo transfer (day 5, aOR = 7.93; P = .03), and endometrial thickness (aOR = 1.96; P = .02).

“We did not find any significant adverse effects for the study population of the intralipid,” said Dr. Singh.

[Presentation title: Effect of Administration of Intravenous Intralipid on Implantation Rates in Women With Implantation Failure after IVF/ICSI: a Randomized Controlled Trial. Abstract O-184]

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