The Power of Observation Academic Article uri icon

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abstract

  • PROBLEM: In the golden age of evidence-based medicine, how should one view the cohort-controlled study of IVIG + anti-TNF-α (Humira) in recurrent in vitro fertilization (IVF) failure patients with an elevated Th1/Th2 cytokine production ratio. METHOD: Critical analysis of the nature of evidence for causation. RESULTS: A better delivery rate and a live birth rate per embryo approaching the estimated maximum possible in patients whose elevated Th1/Th2 ratio corrected to normal compared to those with an incomplete correction is a strong argument for causation. A maximal improvement when treatment was given 61-120 days before embryo transfer suggests a possible mechanism via improving the physiology during follicle development. CONCLUSION: Independent replication to verify results would augment power.

publication date

  • August 2011