Abstract
Backgound: Over the past 15 years we have learned much about recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF) in otherwise healthy women. These women repeatedly fail to achieve successful pregnancy even when high-grade embryos are produced following in vitro fertilization. We have performed a retrospective cohort analysis to determine whether a careful clinical history, specific laboratory testing and targeted treatment can achieve pregnancy success in these women.
Methods: From 2007-2022, we collected data from 1,414 RPL/RIF patients who were evaluated according to the Beer treatment protocol. The Beer protocol uses a multivariate evaluation tool to identify immunological, metabolic and coagulation abnormalities that contribute to RPL and RIF. We examined 13 factors that may interfere with pregnancy, and we tailored our treatment to address these factors.
Results: The mean patient age was 37.8 ± 4.9 years and the mean number of pregnancy failures was 4.0 ± 2.6. The pregnancy success rate with the Beer protocol was 70% overall and even higher when egg quality issues were eliminated. Women who were age matched and untreated served as historical controls, and their pregnancy success rate was 23%. The difference in pregnancy success between treated versus untreated women was significant (P=0.0001).
Conclusion: The Beer treatment protocol for RPL/RIF was associated with significant pregnancy success in this cohort. Future approaches to improve pregnancy outcomes in women with RPL and RIF warrant investigation.