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Review
. 2023 Jul 12;9(4):236-245.
eCollection 2023 Aug 31.

Effect of a 20% intravenous fat emulsion therapy on pregnancy outcomes in women with RPL or RIF undergoing IVF/ICSI: a systematic review and meta-analysis

Greg J Marchand  1 , Ahmed Taher Masoud  1   2 , Hollie Ulibarri  1 , Amanda Arroyo  1 , Catherine Coriell  1 , Sydnee Goetz  1 , Carmen Moir  1 , Atley Moberly  1 , Daniela Gonzalez  1 , Madison Blanco  1 , Harry Randall Craig  3
Affiliations
Review

Effect of a 20% intravenous fat emulsion therapy on pregnancy outcomes in women with RPL or RIF undergoing IVF/ICSI: a systematic review and meta-analysis

Greg J Marchand et al. J Clin Transl Res. .

Abstract

Background and aim: The aim of this study was to evaluate the efficacy a 20% intravenous fat emulsion therapy in women suffering from recurrent pregnancy loss or recurrent implantation failure (RPL/RIF) who are undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Materials and methods: We searched Cochrane Library, ISI Web of Science, MEDLINE, ClinicalTrials.gov, PubMed, and Scopus using relevant keywords during February 2020 for randomized controlled trials (RCTs) comparing the therapy versus placebo or no intervention in women suffering from RPL/RIF and undergoing IVF/ICSI.

Results: We included five RCTs with 840 patients. The intravenous fat emulsion therapy was significantly effective in increasing clinical pregnancy rates compared to the control group (risk ratios [RR] = 1.48, 95% confidence intervals [CI] [1.23, 1.79], P < 0.001). Furthermore, ongoing pregnancy and live birth rates were significantly higher with 20% intravenous fat emulsion therapy RR = 1.71, 95% CI [1.27, 2.32], P = 0.005 and RR = 1.85, 95% CI [1.44, 2.38], P < 0.001. Despite the statistically significant differences, the quality of evidence was only considered moderate, and this was primarily due to high risk of bias in the included RCTs.

Conclusion: Our review provides a moderate level of evidence that intravenous fat emulsion therapy is effective in improving reproductive outcomes among women with RPL/RIF performing IVF/ICSI techniques. Further, investigation is required to ascertain optimal dosage and timing of administration.

Relevance for patients: Women suffering from RPL or RIF may wish to consider discussing with their reproductive endocrinologist the addition of a 20% fat emulsion therapy to planned IVF or ICSI cycles, which may improve outcomes.

Keywords: Clinical pregnancy; Intralipid; Recurrent implantation failure; Recurrent pregnancy loss.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. PRISMA flow diagram of selected studies.
Figure 2
Figure 2. Risk of bias summary.
Figure 3
Figure 3. Forest plot of clinical pregnancy rate.
Figure 4
Figure 4. GRADEpro™ assessment of methodologic quality of evidence.
Figure 5
Figure 5. Forest plot of the ongoing pregnancy rate.
Figure 6
Figure 6. Forest plot of the miscarriage rate.
Figure 7
Figure 7. Forest plot of the live birth rate.
See this image and copyright information in PMC

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