What actually ARE intralipids?
Intralipid is a fat emulsion - which basically means it is fat mixed in with oil and water (mainly soybean oil). It’s given via an intravenous line - meaning it’s ‘injected’ via a catheter directly into your veins. It’s usually used for very ill patients to provide them with extra nutrients. The body then breaks down these fats into essential fatty acids, which are normally found in the food that you eat. so in a healthy individual, with a relatively balanced diet, you would normally get enough of these in your diet to maintain good health
So why would you want to do this in an IVF cycle?
There is actually very little evidence to suggest that you should… but those that ‘love’ this add-on say that it might be helpful in suppressing Natural Killer cell activity, which may then in turn help with implantation on early development of pregnancy.
If you do a google search ‘why would you have an intralipid infusion in IVF?’ You get a number of hits from IVF clinics and doctors who offer this treatment, all suggesting some kind of benefit for women with recurrent implantation failure or recurrent pregnancy loss, stating that ‘studies have shown…’ but then not giving a reference for the studies that showed an advantage.
But a bit further down the page, you’ll find a study from the Journal of Human Reproductive Science in 2018 that states:
Intralipid does not improve live birth rates and is not cost-effective for patients with RIF or RPL and elevated NK cells. This study supports the growing literature demonstrating the minimal benefit of screening for and treating elevated peripheral NK cells.
Ok, so then what’s the evidence for intralipids?
There is little evidence that intralipid infusion improves live birth rate.
At the October 2021 Scientific and Clinical Advances Advisory Committee (SCAAC) meeting, the Committee evaluated the evidence base for immunological tests and treatments. This group were unable to find any well constructed studies that showed any benefit from doing intralipid infusions as part of an IVF cycle. (you can find the minutes of this discussion and the evidence used to inform this discussion on the SCAAC webpage. Just scroll down to the October 2021 meeting)
The SCAAC is a committee of the HFEA (Human Fertilisation and Embryology Authority in the UK)
Is this treatment add-on safe?
Some common minor side effects include headache, nausea, vomiting, dizziness and flushing.
Intralipid is given by intravenous infusion (a drip) that always carries a risk of introducing infectious agents directly into the blood stream. There are some more serious possible side effects, but these are very unlikely. You should always check risks of side effects with your Doctor!
Intralipids are not suitable for people with allergies to eggs, soya beans or peanut oil as they would be at risk of severe reaction. There is also a risk of reactions in patients without known allergies. Those range from minor rashes to serious anaphylaxis with facial swelling and difficulty breathing.
So should you consider it?
Well, I usually say, would you have an MRI looking for a brain tumour if you have a headache?? probably not… but if you’ve had the headache for a long time, and nothing else seems to be working, it’s probably something to discuss with your doctor.
Likewise for this kind of so-far-un-proven add-on.
It’s not a ‘first line’ type treatment as the evidence doesn’t really support it’s use.
In fact there is no evidence at all (that I could find) that says that it will help. But if you’ve had a few transfers of ‘good’ quality embryos without success - well, it’s probably worth a discussion with your Doctor.
If you would like to investigate your options or understand more about recurrent implantation failure or pregnancy loss - please book a time and let's talk more about your situation