Intralipid and fertility
Intralipids are far less expensive than Intravenous Immunoglobulin (IVIG), and initial studies show comparable efficacy for deactivation of natural killer cells and pregnancy rates. Intralipids are well tolerated by patients with few side effects and are created synthetically, unlike IVIG which is a blood product. It takes about two to three hours for the Ιntralipid to be administered through the IV. Throughout the infusion the medical staff will monitor you for any adverse effect.
Evidence from both animal and human studies suggests that Ιntralipid administered intravenously may enhance implantation. Intralipid stimulates the immune system to remove “danger signals” that can lead to pregnancy loss.
What is the frequency of the Intralipid infusion?
In a Natural cycle/IUI the Intralipid infusion is administered when there is a positive pregnancy test, thereafter at 8 and 12 weeks of gestation.
In IVF/ICSI the Intralipid infusion is administered 7-10 days prior to embryo transfer and then at 7-8 weeks gestation and 12 weeks gestation.
This may be continued later in the pregnancy in some patients or sometimes the infusion may be given more frequently and/ or before the period starts.
Only in conditions characterized by severely disordered fat metabolism such as in severe liver damage, acute myocardial infarction, shock, renal insufficiency and uncontrolled diabetes.
Manufacturer’s’ Warnings in Clinical States:
Rare cases of hypersensitivity have been observed in patients allergic to soybean protein, egg yolk and egg whites.
Adverse reactions reported to occur during and/or following infusion of Intralipid include: fever, chills, nausea, vomiting, headache, back or chest pain with dyspnea and cyanosis.
Symptoms and Treatment of Overdose:
When fat emulsion is given in amounts exceeding the capacity of fat elimination the following symptoms may occur: hyperlipidemia, hepatosplenomegaly, jaundice, hemolytic anemia, prolonged clotting time and thrombocytopenia. All symptoms clear in days to week after cessation of fat infusion.
Treatment with Filgrastim medication (Neupogen, Zarzio, Granix)
Filgrastim is a medication that causes the body to generate neutrophils, a type of white blood cell which plays an important role in the immune system. An individual may benefit from Filgrastim if they have experienced multiple miscarriages or failed implantation with IVF. It has often proven successful when other options have failed. Filgrastim is administered either in injection form or as a uterine wash in infertility treatments.
Filgrastim is increasingly utilized for other conditions including the treatment of recurrent miscarriages.
If you are interested in pursuing Filgrastim treatment as a method of achieving success after multiple miscarriages, please contact our center.
Endometrial Scratching For Failure of Implantation
Unsuccessful IVF is difficult to accept but is not uncommon. Embryo implantation is a complex process and some common causes of failure can be due to poor endometrial quality (lining of womb) or a genetically abnormal embryo. Women who have repeatedly failed IVF despite apparently good quality embryos may be candidates for the latest procedure called endometrial scratching which has been shown in several studies to improve the implantation rate in women who have had repeated failures.
The process of endometrial scratching as it relates to embryo implantation is not entirely understood and some questions still remain unanswered. Scientists involved in studies believe that there may be two reasons for the increased implantation rates:
1: Increase of endometrial white blood cells. It appears that endometrial injury increases the production of white blood cells which secrete so called growth factors which in turn control embryo implantation.
2: Gene switching within the endometrium. Scientists speculate that sometimes embryos fail to implant due to genetic switching related to endometrial receptivity. That is, genes responsible for implantation of embryos are not switched on during the time when embryos are supposed to implant. Endometrial scratching may increase expression of genes (switching of genes) thought to be responsible for preparation of endometrium for implantation.
The procedure is usually carried out in the luteal phase of the cycle (i.e. after ovulation) before your treatment. Normally this is done between days 21-26 of the cycle prior to your treatment cycle.
Reflexology is a massage system used to relieve tension and treat illness. It is based on the theory that there are reflex points on feet, hands and head linked to every part of the body. Our collaborator is available for reflexology sessions upon request. Reflexology is applied half an hour before embryo transfer with pre-booked appointments. It is believed that during fertility treatments, reflexology can help both women and men to have reduced levels of stress. Additionally reflexology helps to normalize the menstrual cycle of women, it regulates hormonal levels, it relieves the polycystic ovaries syndrome and endometriosis and it aids the production of healthy sperm and ova. Reflexology can also be applied during the whole gestation.
Acupuncture is the technique where ultra-thin, sterilized needles are inserted into specific acupuncture parts on the body. When the needles are inserted, they reside on channels or meridians. These channels and meridians are pathways in both the exterior and interior of the body. These points can regulate the way that body functions.
Acupuncture is applied usually half an hour before embryo transfer and right after the embryo transfer. Acupuncture increases the blood flow in women’s reproductive organs, including the uterus and the ovaries through sympathetic nervous system inhibition. Our collaborator is available for acupuncture sessions upon request.