[Immunotherapy for prevention of abortion and for improving implantation in extracorporeal fertilization]

In women with a history of recurrent in-vitro fertilization failure (at least three transfers of good quality embryos), there is an increased prevalence of organo-specific and not organo-specific autoantibodies, similar to women with a history of recurrent miscarriage. It is still unknown whether these autoantibodies are causally related to the failure of implantation or merely reflect an underlying systemic disorder. Several therapeutic intervention for the improvement of implantation after in-vitro fertilization and embryo transfer have been tried, including prednisolone (10 mg/d), heparin and aspirin (80-100 mg/d) alone or in combination with immunoglobulins and active immunotherapy using partner's leukocytes. At present, these interventions in combination with IVF should be regarded as experimental, as controlled, randomized and prospective trials in a large number of couples are still lacking.