Some types of infertility may be caused by a slightly overactive immune system. When this occurs the immune system can attack egg, sperm, embryo and even a developing fetus. This can result in difficulty achieving pregnancy, maintaining the pregnancy, or repeated miscarriages.
Natural killer (NK) cells are regulated by the immune system. In women who have autoimmune issues, the NK cells can react abnormally to an implanting embryo, treating it as an invading cell and signalling for the body to attack it.
Intralipidshave been shown to lower the activity of the NK cells component of our immune system. Studies have found that intralipids can help to regulate the NK cells, allowing the embryo to implant on the uterine wall and grow normally. New research has suggested that women who have experienced recurrent miscarriages or multiple failed IUI or IVF cycles as a result of NK cell activation may benefit from the use of intralipids.
Intralipids have a suppressive action on certain components of the mother's immune system, essentially safeguarding the embryo from the immune reactions which might otherwise result in implantation failure.
Worldwide there is less clinical experience with Intralipids than with IVIG, but we have studied their use in our practice, and have found that our patients have enjoyed great success. Many women who have suffered multiple IVF treatment/implantation failures and who are unable to afford more expensive treatment options turn to Intralipids therapy.
Evidence from both animal and human studies suggest that intralipids administered intravenously may enhance implantation. We advocate aggressive treatment of immunologic implantation dysfunction in women undergoing IVF treatment. In cases where there has been NK cell activation we recommend the use of intralipids to down regulate (deactivate) the NK cells. So far, many women who otherwise might not have achieved success with IVF have gone from infertility to family.
About a year ago, we began evaluating the effect of Intralipid in patients who had activated Natural Killer cells, and for whom IVIG therapy would otherwise be indicated. Thus far we have treated more than 30 women with raised NK cell count in the lining of their womb (endometrium) using Intralipid 20%. More than 60% of the patients achieved viable ongoing pregnancies, showing Intralipid therapy to be at least as effective (and perhaps even more so) than IVIG. There were no significant side effects and patient tolerance of this treatment was high. We anticipate that patients receiving Intralipid will soon start reporting on their experience using Intralipid, on various discussion boards.