Evaluation of intralipid effect on pregnancy outcomes in women with recurrent implantation failure: A retrospective cohort study

Atoosa Karimi, Karimi A, Aniseh Dadgar, Dadgar A, Saffari H, Haniyeh Saffari, Vahedi N, Nazanin Vahedi, Saket S, Sasan Saket, Soheila Arefi, Arefi S
International journal of reproductive biomedicine · 2026 · vol. 24(6) , pp. 517–526 · doi:10.18502/ijrm.v24i6.21459 · PMID:42683103 · PMC13530875
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In a retrospective cohort of 270 women with recurrent implantation failure, intralipid administration significantly increased biochemical pregnancy rates and showed positive trends in clinical pregnancy and live birth compared to controls.

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This retrospective cohort study evaluated the impact of intravenous intralipid infusion on pregnancy outcomes in 270 women with recurrent implantation failure undergoing frozen embryo transfer. The intervention group, which received intralipid prior to and during early pregnancy, demonstrated a significantly higher biochemical pregnancy rate compared to the control group receiving standard routine treatment. Although ongoing pregnancy and live birth rates were numerically higher in the intralipid group, these differences did not reach statistical significance. Women diagnosed with endometriosis were explicitly excluded from this study, meaning the findings apply only to patients without this condition. Relevance to endometriosis: the paper excludes patients with endometriosis from its analysis, thereby limiting its direct applicability to that specific patient population.

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Abstract

BACKGROUND: Recurrent implantation failure remains a challenge in assisted reproduction. Intralipid has been proposed as an immunomodulatory intervention to improve outcomes, although evidence remains inconsistent. OBJECTIVE: This study aimed to evaluate the effect of intralipid on pregnancy outcomes in women with a history of at least 2 failed embryo transfer cycles. MATERIALS AND METHODS: In this retrospective cohort study, data of 270 women with ≥ 2 failed embryo transfer cycles, who underwent a subsequent frozen embryo transfer (FET) at Avicenna Fertility Center, Tehran, Iran, from March 2021-2022 were extracted from medical records. Participants were allocated to the intralipid group (n = 132), receiving 100 mL intravenous intralipid 20% 1 wk before FET, if beta-human chorionic gonadotropin was positive, the same dose was given every 4 wk until the end of the first trimester, or to the control group (n = 138), undergoing routine FET treatments. Outcomes included biochemical, clinical, and ongoing pregnancy, abortion, and live birth. RESULTS: Biochemical pregnancy rate was significantly higher in the intralipid group compared with controls (51.5% vs. 37.7%, p = 0.022). Clinical pregnancy (43.2% vs. 36.2%), ongoing pregnancy (28.8% vs. 18.8%), and live birth (25.8% vs. 17.4%) also favored the intralipid group, although these differences did not reach statistical significance (p > 0.05). Abortion rates were comparable between groups (25.8% vs. 21.0%, p = 0.357). CONCLUSION: Intralipid may improve biochemical pregnancy rates and shows a non-significant positive trend in other pregnancy outcomes in recurrent implantation failure cases, warranting confirmation in larger randomized controlled trials.
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A. Karimi: Designed the study and was responsible for implementation, data collection, and manuscript writing. A. Dadgar: Performed data cleaning, conducted the analysis, interpreted the results, and contributed to manuscript writing. H. Saffari and N. Vahedi: Collected and reviewed the patient records and entered the data into the data table. S. Saket: Contributed to manuscript writing and performed language editing. S. Arefi: Corresponding author, supervisor, and principal investigator of the project. All authors approved the final version of the manuscript.

Coi Statement

The authors declare that there is no conflict of interest.

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