Effect of Immunomodulatory Treatment on IVF (in Vitro Fertilization) Outcomes in Patients With KIR AA Genotype
Condition: Immunomodulatory Drugs; Killer-cell Immunoglobulin-like Receptors (KIRs); KIR Alleles (KIR AA)
Study type: Interventional

Summary: 
      The aim of the study is to investigate the immune cause of recurrent implantation failure
      (RIF) and the role of immunomodulatory treatment in IVF (in vitro fertilization) patients
      that have a KIR AA genotype. We compared pregnancy rates in Group KIR AA without
      immunomodulatory treatment, and pregnancy rates in Group KIR AA with immunomodulatory
      treatment.
    

Detailed description: 
      The investigators included patients that underwent an (IVF )in vitro fertilization procedure
      in CALLA IVF Clinic Oradea - Romania, between 01 January 2022 and 31 December 2023.

      Recurrent implantation failure (RIF) impacts 10% of couples undergoing in vitro fertilization
      (IVF), prompting the exploration of tailored treatments to address underlying causes and
      enhance implantation rates. Among these causes, maternal immune tolerance toward embryos has
      garnered significant attention in RIF research, with Killer-cell immunoglobulin-like
      receptors (KIRs) on natural killer (NK) cells emerging as key players in maternal-fetal
      immune interactions. The investigation into KIR alleles (KIR AA) in RIF is rooted in the
      theory that specific KIR-HLA-C combinations may contribute to implantation failures. Recent
      studies suggest that KIR genotyping could serve as a predictive tool for RIF, potentially
      enabling personalized approaches in assisted reproductive technology, such as
      immunomodulatory treatments and tailored embryo transfers.

      All couples underwent IVF ovarian stimulation, with various factors documented including age,
      type of infertility, number of oocytes retrieved, number of embryos produced, pregnancy rate.

      A total of 65 patients were enrolled in this study, with 24 patients included in group A,
      this is the group with KIR AA and 41 patients included in the group B, meaning the group with
      the KIR Bx Inclusion criteria: patients with an infertility diagnosis having an IVF procedure
      with at least two top-quality embryo to transfer (according to Gardners criteria), that sign
      the accord to be enrolled in this study with a negative test for chronic endometritis and
      normal hysteroscopic findings, also patients that have an history of recurrent pregnancy loss
      and have an IVF indication will be tested in the first round.

      Exclusion criteria: absence of signed consent, refusal of hysteroscopy, uterine
      abnormalities, thin endometrium, endometrial polyps, pelvic cancer, acute inflammatory
      disease, Asherman syndrome, chronic endometritis, oocyte or spermatozoa donor.

      The KIR AA group experienced improved pregnancy outcomes compared to those in the same cohort
      who did not undergo prior immunomodulatory treatment
    

Intervention name(s): Killer-cell immunoglobulin-like receptors (KIRs) testing
Intervention type(s): Diagnostic Test
Intervention description(s): patients were tested for KIRs, and based on the divided in the 2 arms. Patient from ARM KIR AA received immunomuodulatorc treatment.
Other intervention name(s): immunomodulatory treatment for KIR AA
Intervention MeSH terms: Immunoglobulins; Immunoglobulins, Intravenous; Antibodies
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment