Evaluating etanercept for IVF implantation

This study looked at etanercept (Enbrel) for women who have had repeated unsuccessful in vitro fertilization (IVF). It found that etanercept led to good pregnancy rates in these patients.

The uterus forms a connection between the vagina, which is open to the outside, and the inside of the body. If harmful bacteria reach the uterus, a pelvic infection could develop. It is the immune system’s job to identify and eliminate potentially harmful foreign cells. However, an embryo also has foreign cells, with different genetic material from the woman. Each month following ovulation, the immune system within the uterus changes the way it responds, to prepare for a potential pregnancy.

Having the uterus be receptive is essential for an embryo transfer (ET). However, some women do not become pregnant even after repeatedly undergoing ET. This condition is known as repeated implantation failure (RIF). It is believed that an overactive immune system may contribute to RIF.

Etanercept is a medication that affects the immune system. This medication can improve pregnancy rates for women with rheumatoid arthritis, which is an autoimmune disease. It is not clear whether etanercept can improve ET outcomes for women with RIF.

This study included 83 women who were undergoing IVF and embryo transfer (ET). The average age of the women was 37.9 years. All the patients had at least 3 previous unsuccessful ETs. Most of the patients (68.7%) used donor eggs to create their embryos. All of the women received four doses of etanercept in the days around their ET.

74.7% of patients had a pregnancy visible on ultrasound. 62.7% of the patients had an ongoing pregnancy, which typically means at least 10 weeks. 16 of the pregnancies had complications. This included 4 cases of preeclampsia, which is related to the immune system.

At the time the study concluded, 32 patients had given birth to 49 babies. 17 of the births were preterm. There were no side effects from the etanercept.

This study found that etanercept improved pregnancy rates following ET for women with RIF.

This was a small initial study and did not include a comparison group of patients not using etanercept. Also, more studies are needed to determine the best dose of etanercept for this purpose.