The effect of prednisolone on endometrial uterine NK cell concentrations and pregnancy outcome in women with reproductive failure. A retrospective cohort study.

COOPER, Sophie, LAIRD, Susan, MARIEE, Najat, LI, Tin Chiu and METWALLY, Mostafa (2019). The effect of prednisolone on endometrial uterine NK cell concentrations and pregnancy outcome in women with reproductive failure. A retrospective cohort study. Journal of reproductive immunology, 131, 1-6.

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Official URL: https://www.sciencedirect.com/science/article/pii/...
Link to published version:: https://doi.org/10.1016/j.jri.2018.10.001

Abstract

This retrospective study of prospectively collected data examines the effect of prednisolone therapy on raised uterine Natural Killer cell (uNK) concentrations and pregnancy outcomes in women with recurrent miscarriage (RM) and recurrent implantation failure (RIF) after IVF/ICSI treatment. 136 women diagnosed with RRF who had a timed midluteal endometrial biopsy taken for uNK cell analysis were included. Women with high uNK cell concentrations (n = 45) were treated with prednisolone (10 mg/day) for one month, after which a second biopsy was taken for repeat uNK cell analysis. Women for whom prednisolone caused a decrease in uNK cell concentrations continued on prednisolone until 12 weeks of pregnancy. Pregnancy outcomes (live birth, miscarriage and implantation rates) and pregnancy complications were compared for women who received prednisolone and those who did not. Results showed that the prevalence of high uNK cells was 33.1%. Prednisolone significantly decreased the uNK cell concentration (P < 0.001), however reduction to normal limits was achieved in only 48.3% of patients. There was no difference in any of the pregnancy outcomes or complications between women who had received prednisolone and those who had not. In conclusion, this study showed a relatively high prevalence of raised uNK cells in women with recurrent reproductive failure and confirmed the effect of prednisolone on reducing uNK cell concentrations. We found however no evidence for a significant beneficial effect for prednisolone therapy on pregnancy outcomes. Until the results of an adequately powered RCT become available however, these findings should be considered preliminary. [Abstract copyright: Copyright © 2018 Elsevier B.V. All rights reserved.]

Item Type: Article
Additional Information: ** From PubMed via Jisc Publications Router **Journal IDs: eissn 1872-7603 **Article IDs: pubmed: 30390547; pii: S0165-0378(18)30160-8 **History: received 31-05-2018; submitted 31-05-2018; revised 19-08-2018; accepted 11-10-2018
Uncontrolled Keywords: Endometrium, Prednisolone, Recurrent implantation failure, Recurrent miscarriage, uNK cells
Identification Number: https://doi.org/10.1016/j.jri.2018.10.001
SWORD Depositor: Margaret Boot
Depositing User: Margaret Boot
Date Deposited: 29 Nov 2018 11:36
Last Modified: 29 Nov 2018 11:36
URI: http://shura.shu.ac.uk/id/eprint/23368

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