Cell microchimerism in patients with recurrent spontaneous abortion: preliminary results

The goal of this study was to determine the prevalence of non-host male cell microchimerism in a group of women with a history of recurrent spontaneous abortion (RSA). The detection of male cell microchimerism was based upon amplification of a fragment of Y chromosome DNA obtained from peripheral blood mononuclear cells from the mother. The amplification products were electrophoresed, transferred onto nylon membranes and hybridized with a specific 32P-labelled probe. The products were visualized by autoradiography. Seventy-seven patients with RSA were studied. Some patients (42.8%) had received immunotherapy for RSA using live mononuclear cells from male donors. Of the 77 patients 46 (59.7%) were positive for the selected Y chromosome sequence, 22 (28.6%) had no evidence of Y chromosome DNA and in nine (11.7%) cases the chimeric status could not be defined since the amplified band was too faint to be clearly assigned as positive. Twenty patients were pregnant at the time of sampling. There were no statistically significant differences among the different variables studied: age of the mother, number of previous pregnancies, number of previous immunotherapeutic inoculations or period of time between the last inoculation and sampling. Male cell microchimerism has been reported in some but not all women who have given birth to male children. The dynamics for the establishment of this chimeric status and its persistence have not been defined. We found that most patients with RSA (59.7%) were positive for microchimerism but that this could not be correlated with abortion, current pregnancy or leukocyte immunotherapy. A prospective study is being undertaken to determine if there is a subset of patients negative for chimerism who become positive after alloimmunotherapy with male lymphocytes and have an improved prognosis for successful pregnancy.