Narrow Results

The objective of this study is to investigate the significance of natural killer (NK) cells and interleukin-2 in uterus in the early embryo loss (or resorption), and to elucidate the immunological modulation of maternal-fetal interface with Chinese herbal medicine Radix Scutellariae (Huang Qin) and Rhizoma Atractylodis (Bai Zhu). Lipopolysaccharide (LPS) was given via the tail vein to induce abortion in mice at day 7 of gestation. Uterine NK cells and IL-2 contents were analyzed by immunohistochemistry and enzyme linked immunosorbent assay (ELISA), respectively. The number of NK cells was found to be much higher (mean = 180 ± 39) in the decidua of LPS-treated abortion mice. But when the Chinese herbal medicine was used to prevent LPS-induced abortion, less NK cells (mean = 11 ± 4) were counted (p < 0.01). The mean value of IL-2 in LPS-treated mice was 5.25 ± 2.5938 pg/mg protein, higher than (p < 0.05) that of the herb prevention group, which was only 1.86 ± 0.9789 pg/mg protein. The results therefore indicate that the increase of NK cells in the decidua and IL-2 contents in the uterus in LPS-treated mice is closely related to the embryo loss, and that the Chinese herbal medicine prescription composed of Radix scutellariae and Rhizoma atractylodis has an anti-bortive effect through inhibition of maternal-fetal interface immunity.

The intravenous fat emulsion, intralipid, has been hypothesised to be an effective and safe treatment for repeated in vitro fertilisation (IVF), implantation failure and pregnancy loss. This exploratory, retrospective cohort study determined pregnancy outcomes and documented adverse events associated with intralipid use. Ninety-three women were identified as having received intralipid for a history of repeated unsuccessful IVF cycles and pre-viable pregnancy loss in two Australian IVF units that independently recruited between October 2014 and July 2016. Pregnancy outcomes and adverse events were recorded in fresh and frozen embryo transfer cycles in which the infusion was administered. The 93 women who received intralipid had a clinical pregnancy rate of 40.0%, compared with 35.0% in 651 age-matched controls undergoing IVF, which was not significantly different. The intralipid group had a livebirth rate of 35.7%. Apart from flushing, which was experienced by one individual, there were no adverse events associated with intralipid use. As a prelude to definitive evidence of benefit, we did not identify a safety concern or reduced pregnancy rates in intralipid users compared to controls. Indeed, these outcomes were better than expected in a poor prognosis group. This data supports an argument for large, randomised controlled trials to determine the benefit of intralipid in the treatment of recurrent implantation failure or miscarriage.