BONUS 273: Immunotherapy During IVF

August 21, 2020

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

Episode Sponsor:

Infertility Coaching with Heather Huhman

Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Sylvia lives in the United Arab Emirates. She asks how to treat a peritoneal inclusion cyst that started after her laparoscopic surgery to remove fibroids, and if she can carry a pregnancy successfully with this cyst.
  • Morgan’s husband had a vasectomy 14 years ago and had it reversed just six months ago. After completing their first IUI cycle, she asks about improving her low progesterone levels, ovulating earlier, and other tests that may be indicated.
  • Inez lives in the UK and has DOR. Their first fresh transfer failed, but a FET gave them their son. She asks about patients with low AMH having a second child and whether a frozen transfer would be advised again.
  • Krista had her first IVF cycle recently but ended up with only one mature egg that didn’t fertilize with ICSI. She asks about producing more mature eggs and the timing of her retrieval.
  • Andrea has PCOS and high AMH. She asks if it’s possible for her to ovulate naturally and if she’s at higher risk than normal for conceiving twins.
  • Priyanka lives in India and has endometriosis. She had a cyst removed in 2009, and intestinal lesions were removed in 2018. She asks about increasing her follicle size with vitamins and supplements.

Dr. Rodgers and Heather continue the episode by discussing undergoing immunotherapy during IVF:

  • ASRM published a guideline for using immunotherapy during IVF, based on a review of 96 studies. What does it mean to review past studies, and what are the limitations of this method of research?
  • Each recommendation in the guide is given a rating for quality of evidence and strength of evidence. Can you walk us through both of those?
  • Aspirin
  • Corticosteroids
  • Granulocyte Colony-Stimulating Factor (G-CSF) and Granulocyte/Macrophage Colony-Stimulating Factor (GM-CSF)
  • Intravenous Fat Emulsions (Intralipids)
  • Intravenous Immunoglobulin (IVIG)
  • Adalimumab (Humera)
  • Peripheral Mononuclear Cells
  • Seminal Plasma
  • Spermatozoa, Antibody-Free Preparation
  • Tacrolimus (Prograf)
  • Overall, what are the conclusions about immunotherapy during IVF?
  • This guide was produced several years ago. Do you think the science behind immunotherapy has changed since then?
  • What questions does this guide leave unanswered for future research?
  • Is there anything else you’d like to add?
  • What words of hope would you offer to couples who have not been successful with IVF and are looking for solutions?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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