Background: Recurrent pregnancy loss (RPL) is a multifactorial condition, and immunological therapies have been explored in women with recurrent miscarriage or RPL when immune dysregulation is suspected. This review evaluated pregnancy outcomes after intralipid therapy in women with RPL. Methods: A systematic review based on PRISMA principles was conducted using PubMed, Embase, Scopus, and the Cochrane Library. We consider original studies evaluating intralipid or lipid emulsion therapy in women with RPL, recurrent miscarriage, or related reproductive failure populations and reporting pregnancy outcomes. Data on study characteristics, treatment regimens, and outcomes were extracted and analyzed qualitatively. Results: Four studies published between 2015 and 2025 were included, conducted in China, the United States, France, and Japan. Study designs included one prospective randomized trial, one comparative study, and two retrospective cohort studies. One study focused on an unexplained recurrent spontaneous abortion population, while the others included mixed recurrent pregnancy loss miscarriage and recurrent implantation failure populations. Intralipid showed outcomes comparable to intravenous immunoglobulin in two studies, a significantly higher live birth frequency than controls in one recurrent miscarriage subgroup, and no clear improvement versus historical controls in another study. Conclusions: intralipid have benefit in selected women with RPL, and results remain inconsistent and limited by heterogeneous populations and study designs.
Abdulaal et al. (Wed,) studied this question.