Twenty years of experience with paternal immunotherapy: a role as an enhancer of the in vitro fertilization

• Autores: Fernandez, Pablo Mariano; Belen, S.; Gonzalez, Veronica Andrea; Fainboim, Leonardo
• Año de publicación: 2020
• Idioma: inglés
• Tipo de recurso: documento de conferencia
• Materia: Recurrent Spontaneous Abortion; Paternal Immunotherapy; InVitro Fertilization
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Unexplained Recurrent Spontaneous Abortion (URSA) is a common pregnancy complication that implies loss within the first 20 weeks of gestation. Immunological mechanisms seem to participate in their development. Unexplained infertility has also been associated with these mechanisms. Paternal immunotherapy (PIT) is used worldwide as treatment for URSA, but protocols differ mainly in amount of mononuclear cells, routes of administration, or single versus several doses. Herein we report results from the use of PIT in a cohort of 416 primary URSA, 92 secondary URSA and 298 infertile women. All patients followed a multiple intra-dermal injection of paternal mononuclear cells until detection of more than 50% blocking activity in a mixed lymphocyte reaction (MLR-Bf). Patients and controls were followed during 2 years since their first consultation. Statistical comparisons were done by two-tailed unpaired t-test and Fisher?s exact test, considering differences significant when P<0.05. Primary URSA and infertile women showed a similar pattern achieving values of MLR-Bf above 50% after 3 PIT in 46% and 49% of patients, respectively. 60% of secondary URSA patients reached the desired value after only 3 injections. When analyzing outcome as succesful pregnancies, a live birth was present in 58% (n=242) of all primary URSA treated women vs. 23% in the control group (p< 0.0001, OR: 4.7, CI 95%: 3.3-6.6). Secondary URSA showed live births in 61% of patients (n=56) vs 28% in controls (p< 0.0001, OR: 4.0; CI 95%: 2.2-7.2). 33% of Infertile patients showed live births (n=99) vs 21% in controls (p=0.0009; OR: 1.9; CI 95%: 1.3-2.8). Analysis showed that best results were obtained in women between 20-35 years old. Treated women requiring IV fertilization became pregnant after 1.37±0.67 procedures (median: 1; range: 1-3) vs controls that required 2.75±0.84 (median: 3; range: 1-5) (p=<0.0001). These results confirm and extend the success of PIT for treatment of URSA and Infertile patients.
Fil: Fernandez, Pablo Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina
Fil: Belen, S.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina
Fil: Gonzalez, Veronica Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina
Fil: Fainboim, Leonardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina
LXIII Reunión Anual de la Sociedad Argentina de Investigación Clínica; LXVIII Reunión Anual de la Sociedad Argentina de Inmunología y Reunión Anual de la Sociedad Argentina de Fisiología
Buenos Aires
Argentina
Sociedad Argentina de Investigación Clínica
Sociedad Argentina de Inmunología
Sociedad Argentina de Fisiología