The question
Do you administer Intralipid/IVIG even if I’m a patient of another fertility clinic?
Answer from Dr. Geoffrey Sher
Absolutely, we do
- Unlocking the potential of intralipid therapy in IVF: a revolutionary approach to enhancing Implantation
Intralipid (IL) is not just any solution; it’s a medical marvel. Picture this: tiny droplets of lipid, similar to what you’d find in soybean oil and egg yolks, floating in water. This concoction, when administered intravenously, is a powerhouse of essential fatty acids. It includes linoleic acid, an omega-6 fatty acid, and alpha-linolenic acid, an omega-3 fatty acid. Comprising 20% soybean oil, 1.2% egg yolk phospholipids, 2.25% glycerin, and a predominant 76.5% water, IL is a crucial player in medical treatments, especially in the realm of in vitro fertilization (IVF).
The secret behind its effectiveness? IL acts as a gentle persuader, activating peroxisome proliferator-activated receptors (PPARs) found in NK cells. This activation leads to a decrease in NK cell cytotoxic activity, enhancing the chances of successful embryo implantation. Interestingly, IL shares a common ingredient with Propofol, a sedation agent used in egg retrieval processes, which might offer an added benefit in cases of immunologic implantation dysfunction.
IL’s magic doesn’t stop there. It modulates immune cell mechanisms, primarily by reducing the activity of overzealous natural killer cells (NKa). This effect is amplified when IL is used alongside corticosteroids like dexamethasone, prednisolone, and prednisone, which work to suppress pro-inflammatory cytokines.
But how effective is IL in reality? Astoundingly, IL can successfully down-regulate NKa in about 80% of cases within 2-3 weeks, making it a cost-effective alternative to other treatments with fewer side effects. Its impact can last between 4-9 weeks, especially when administered early in pregnancy.
However, it’s essential to understand that IL’s effects on NKa take time. Therefore, expecting immediate results in laboratory tests post-treatment isn’t realistic.
In specific scenarios, like autoimmune implantation dysfunction in IVF, the use of IL is particularly promising. Combining IL with daily oral dexamethasone, starting with ovarian stimulation and continuing until the 10th week of pregnancy, significantly increases the likelihood of a successful pregnancy. The treatment involves an initial infusion of IL (100ml of 20% IL in 500cc saline) about 10-14 days before embryo transfer, followed by a second infusion after a positive pregnancy test.
For alloimmune implantation dysfunction cases, the approach varies slightly. The same IL infusion protocol is applied, but oral prednisone is used instead of dexamethasone, and IL infusions are repeated every 2-4 weeks up to the 24th week of pregnancy.
While IL is generally safe, it’s not suitable for everyone. It’s contraindicated in conditions like severe liver damage, acute myocardial infarction, shock, and severe infections like sepsis. Moreover, patients with allergies to soybean protein, egg yolk, or egg whites, or those with disturbed fat metabolism, should avoid IL. During infusions, some might experience transient side effects like fever, chills, or nausea.
The administration of IL is precise: a 500 ml 20% IL solution infused over about three hours, with careful monitoring during the first half-hour. The corticosteroid treatment varies depending on whether the patient has autoimmune or alloimmune implantation dysfunction, but the ultimate goal is always a successful and healthy pregnancy.
Intralipid therapy is revolutionizing the way we approach IVF treatments impatient to have an immunologic implantation dysfunction (IID) With natural killer cell activation (NKa), offering a beacon of hope for many aspiring parents. With its intricate balance of scientific precision and medical insight, IL stands as a testament to the advancements in reproductive medicine.
Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure:
- From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) ; https://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link ;https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
If you would like to have an online consultation with me, please email Patti Converse at concierge@sherivf.com and she will arrange it for you.
Geoffrey Sher MD
Sher Fertility Solutions (SFS)
General information only, not medical advice for your own situation. For that, book a consultation.