The effectiveness of IVIG therapy in pregnancy and live birth rate of women with recurrent implantation failure (RIF): A systematic review and meta-analysis

Recurrent implantation failure (RIF), as a challenging problem in human reproduction, is widely improved by intravenous immunoglobulin (IVIG), especially in patients with immunologic abnormalities. In this meta-analysis, we evaluated the results of the studies in which RIF women were treated with IVIG, and pregnancy, live birth, miscarriage and implantation rate were assessed as the result of treatment. A systematic search was conducted in MEDLINE (PubMed), Embase, Cochrane Library, Google Scholar, ProQuest and clinicaltrail.gov. Two cohorts, two cross-sectional and one quasi experimental studies were included in this study. Four out of five studies were included in meta-analysis and remained one study was narratively discussed. Data analysis was conducted by RevMan 5.2 software. Our meta-analysis results demonstrated that there was a significant difference in the pregnancy rate of cohorts (OR = 1.82, 95% CI = 1.14-2.89, P = 0.01) and cross-sectional studies (OR = 11.12, 95% CI = 6.43-19.23, P < 0.00001), live birth rate of cohorts (OR = 2.17, 95% CI = 1.30-3.61, P = 0.003) and cross-sectional studies (OR = 7.57, 95% CI = 4.53-12.64, P < 0.00001) in the IVIG group when compared to the control group, but there was no significant difference in the miscarriage rate. In conclusion, IVIG may be a beneficial therapeutic strategy in RIF patients selected according to relevant immunological disturbances. However, final conclusions on the efficiency of the treatment must await prospective, randomized controlled trials of sufficient size.