Page 20 - JCTR-9-4

Journal of Clinical and Translational Research 2023; 9(4): 236-245

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

REVIEW ARTICLE

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 *, Ahmed Taher Masoud , Hollie Ulibarri , Amanda Arroyo , Catherine Coriell , Sydnee Goetz ,
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Carmen Moir , Atley Moberly , Daniela Gonzalez , Madison Blanco , Harry Randall Craig 3
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1 Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, United States of America, Fayoum University Faculty of Medicine, Fayoum,
Egypt, Fertility Treatment Center, Tempe, Arizona, United States of America
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ARTICLE INFO ABSTRACT
Article history: Background and Aim: The aim of this study was to evaluate the efficacy a 20% intravenous fat
Received: April 19, 2023 emulsion therapy in women suffering from recurrent pregnancy loss or recurrent implantation failure
Revised: June 10, 2023 (RPL/RIF) who are undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
Accepted: June 11, 2023 Materials and Methods: We searched Cochrane Library, ISI Web of Science, MEDLINE,
Published online: July 12, 2023 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
Keywords: from RPL/RIF and undergoing IVF/ICSI.
Intralipid Results: We included five RCTs with 840 patients. The intravenous fat emulsion therapy was
Clinical pregnancy significantly effective in increasing clinical pregnancy rates compared to the control group (risk ratios
Recurrent pregnancy loss [RR] = 1.48, 95% confidence intervals [CI] [1.23, 1.79], P < 0.001). Furthermore, ongoing pregnancy
Recurrent implantation failure 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
*Corresponding author: significant differences, the quality of evidence was only considered moderate, and this was primarily
Greg J. Marchand due to high risk of bias in the included RCTs.
Marchand Institute for Minimally Invasive Conclusion: Our review provides a moderate level of evidence that intravenous fat emulsion therapy
Surgery, Mesa, Arizona, United States of is effective in improving reproductive outcomes among women with RPL/RIF performing IVF/ICSI
America. techniques. Further, investigation is required to ascertain optimal dosage and timing of administration.
Tel: +1 4809990905; +1 4809990801 Relevance for Patients: Women suffering from RPL or RIF may wish to consider discussing with
Email: gm@marchandinstitute.org their reproductive endocrinologist the addition of a 20% fat emulsion therapy to planned IVF or ICSI
cycles, which may improve outcomes.
© 2023 Author(s). This is an Open-Access
article distributed under the terms of the
Creative Commons Attribution-Noncommercial
License, permitting all non-commercial use, 1. Introduction
distribution, and reproduction in any medium,
provided the original work is properly cited. Recurrent pregnancy loss (RPL) is the recurrent miscarriage of intrauterine pregnancies [1].
Exact definitions vary, but consensus statements by major US and European Obstetrical
groups define RPL as the failure of two or more pregnancies, <12 weeks gestation, which do
not necessarily have to be consecutive [1,2]. Some groups have included the loss of a single
pregnancy in the second trimester to meet this criteria [3], while others require three first
trimester miscarriages to meet their definition [4]. Natural spontaneous miscarriage occurs
in at least 25% of human pregnancies, when pregnancy is detected early and regularly, as
undetected miscarriages are also common [5,6]. Recurrent implantation failure (RIF) refers
to the failure of pregnancy in spite of transferring a healthy embryo after three or more

DOI: http://dx.doi.org/10.18053/jctres.09.202304.23-00060