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Immunotherapy for recurrent miscarriage
T F Porter1, Y LaCoursiere, J R Scott
1LDS Hospital, Maternal-Fetal Medicine, 8th Avenue and C Street, Salt Lake City, Utah 84105, USA. flint.porter@intermountainmail.org
The Cochrane Database of Systematic Reviews
|April 21, 2006
Summary
Immunotherapies like paternal leukocyte immunization and intravenous immune globulin do not significantly improve live birth rates in women with recurrent pregnancy loss. These treatments showed no significant benefit over placebo for improving subsequent live births.
Area of Science:
- Reproductive Immunology
- Obstetrics
- Clinical Trials
Background:
- Immunological factors are implicated in unexplained recurrent pregnancy loss (RPL).
- Immunotherapies have been explored as treatments for RPL.
- Paternal leukocyte immunization and intravenous immune globulin (IVIG) are among these therapies.
Purpose of the Study:
- To review the efficacy of immunotherapies in improving live birth rates for women with unexplained RPL.
- To assess treatments including paternal leukocyte immunization and IVIG.
Main Methods:
- Systematic review of high-quality randomized controlled trials.
- Searched major databases (Cochrane, MEDLINE, EMBASE) up to 2005.
- Included women with ≥3 miscarriages, ≤1 live birth, and no identified non-immunologic causes.
Main Results:
- Twenty trials were analyzed.
- Paternal cell immunization (12 trials) showed no significant difference in live births (Peto OR 1.23, 95% CI 0.89-1.70).
- Third party donor cells, trophoblast membranes, and IVIG also demonstrated no significant benefit over placebo.
Conclusions:
- Current evidence suggests immunotherapies do not offer a significant advantage over placebo for RPL.
- Paternal cell immunization, donor leukocytes, trophoblast membranes, and IVIG are not proven effective.
- Further research may be needed to identify effective RPL treatments.