AB0588 ADALIMUMAB FOR IMMUNE RELATED INFERTILITY: EFFICACY AND SAFETY FROM PROSPECTIVE FRENCH MULTICENTER REGISTRY

Background Recurrent miscarriage (RM) is a frequent condition affecting about 1–3 % of couples and one the most frustrating difficult areas in reproductive medicine since etiology often unknown evidence-based diagnosis treatment strategies are scarce. Likewise, recurrent implantation failure (RIF) considered after at least 3 unsuccessful transfers good quality embryos, remains unexplained 45 infertile couples. Objectives The primary objective this study was to describe real-life prospective cohort women with RM and/or RIF under adalimumab, analyze impact on live birth rates evaluate its safety. Methods French infertility multicenter FALCO registry an ongoing from 2017 including patients miscarriages failures several university hospitals. Inclusion criteria were [1] before 12 weeks gestation 2 embryos transfers; [2] absence any cause for such as uterine, genetic, infectious, hormonal, thrombophilia autoimmune diseases. following data collected: Clinical age, number pregnancies, consecutive miscarriages, body mass index, tobacco alcohol use, tea or coffee consumption during pregnancy, dietary habits, presence endometriosis, adenomyosis assessment uterine cavity by hysteroscopy hysterosonography. Laboratory analysis usual etiological screening: parental karyotypes, ovarian reserve parameters (FSH (IU/L), LH Estradiol (pg/ml), AFC (Antral Follicular Count), AMH rate (ng/ml)), thyroid-stimulating hormone (TSH) levels (mUI/l) biomarkers immune origin (antinuclear antibodies, anti TPO/TG). Results Overall, between December 2022, 2686 pregnancies 395 included follow-up. These had history 102 (26%), 275 (70%) both 18 (4%). median gravidity 4 [2-6]. Regarding immunity biomarkers, 263 various autoantibodies (66,6%): 130 (33%) antinuclear antibodies (>1/80e), antiphospholipid (5%), 44 positive thyroid peroxidase (11%), 24 anti-thyroglobulin anti-transglutaminase (11%). Most recent count 1.73 [0.87, 3.24]. Among overall there 1384 (73,6%), 269 births (14,3%), 89 abortions (4,7%), medical terminations (1,3%), 55 over (2,9%) 58 extrauterine (3,1%) 494 treated received immunomodulatory treatment. these therapies: steroids 332 cases (12,4%), hydroxychloroquine 185 (7%), intralipids (3,8%), adalimumab 69 (2,6%). Patients pregnancy significantly higher cumulative than those untreated ones: OR: 3.52 [1.63 - 7.61]; p < 0.01 adjustment associated (progesterone, aspirin, vitamin D, prednisone). Adverse events Adalimumab reported 7 women: herpes zoster reactivation cases, cystitis bronchitis no congenital malformation maternal deaths. Conclusion In large RIF, has been effective obtain pregnancy. Reference [1]Adalimumab related infertility: efficacy safety Acknowledgements: NIL. Disclosure Interests None Declared.