Intralipid infusions during IVF: hype or help?

23 Oct Intralipid infusions during IVF: hype or help?

Are intralipid infusions helpful  during IVF treatment? No, if you believe fertility guru Robert Winston. He tweeted: ‘Intralipids are peddled for so-called immune infertility. Yet another remedy being used without real evidence it works.’ Is he right? Let’s take a close look at intralipids to see if they work for fertility patients or not.

Intralipid infusion therapy isn’t new. Since the 1960s, intralipids have been given intravenously to patients to boost nutrition after operations. Premature babies get them, too. A blend of soya bean oil, egg yolk, glycerin and water, intralipids infuse your body with calories. You might not make these essential fatty acids yourself.

Early research was promising. UK researchers gave intralipid infusions to 50 women. All had been through numerous unsuccessful IVF cycles. Half of them got pregnant after taking the intralipids. The miscarriage rate was higher for another group who weren’t given intralipids. Small study, but an interesting one.

But a 2018 study into intralipid infusions and pregnancy loss found no evidence infusions made any difference to the live birth rate. This came on top of another study, two years earlier, that said implantation rates were not improved after intralipids.

So what’s the clinical position now? Some doctors still think NK cells in the womb lining threaten embryos. Intralipids might, they say, lower the risk of that happening. But larger randomized trials into IVF and intralipids are needed to truly prove this.

So we have small-scale research. And clinics’ own approaches, based on their experience. Who to believe? Some unscrupulous clinics have undoubtedly overplayed the NK cell threat. Anxious IVF patients are soft targets for hard marketers. Being told your body may be sabotaging your embryo is a mortifying suggestion. IVF patients will pay for anything that improves their chances.

Thankfully, responsible clinics are less aggressive. They explain to patients that intralipid infusions may affect the immunological conditions of their wombs. That elevated NK cells on the surface of the lining may be suppressed. That implantation rates may be improved. That infusions may benefit certain patients, based on their specific fertility history.

If you’ve had miscarriages, repeated implantation failure and have elevated NK levels, intralipid infusion therapy is certainly still an option. Discuss it with your clinic. And ask whether a steroid called Prednisolone, which also alters the immunological conditions in your uterus, is worth trying first.

A typical course of IVF intralipid treatment starts seven days before your scheduled egg retrieval. A second infusion is often done on your embryo transfer day. Some clinics propose a third infusion immediately after a positive pregnancy test. And then monthly ones till the 13-week mark.

How much do intralipid infusions cost? In the UK, it’s a minefield. Some fertility clinics will only do them if you’re having treatment with them. Other independent practitioners  accept anyone. Expect to pay £250 for one treatment.

Our verdict on intralipids during IVF? Be realistic. Don’t expect miracles. Don’t have them at all if you’ve got an egg or soya allergy or might react badly to a cannula in your arm. There’s also a small chance of a headache, nausea and vomiting. Be guided, ultimately, by your clinic.