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Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage

Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage

Published on: August 4, 2021

Immunotherapy for recurrent miscarriage.

Luchin F Wong¹, T Flint Porter, James R Scott

¹Maternal-Fetal Medicine, Intermountain Healthcare, Murray, Utah, USA, 84132.

The Cochrane Database of Systematic Reviews

|October 22, 2014

Summary

This summary is machine-generated.

Immunotherapies like paternal leukocyte immunization and intravenous immunoglobulin do not improve live birth rates for women with unexplained recurrent pregnancy loss. This review found no significant benefits over placebo for these treatments.

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Area of Science:

Reproductive Immunology
Clinical Obstetrics
Evidence-Based Medicine

Background:

Immunological aberrations may contribute to miscarriage in some women.
Recurrent pregnancy loss (RPL) affects numerous women, prompting investigation into various treatments.
Immunotherapies are explored for unexplained RPL when other causes are ruled out.

Purpose of the Study:

To evaluate the efficacy of immunotherapies in improving live birth rates for women with unexplained recurrent miscarriages.
To assess treatments including paternal leukocyte immunization and intravenous immunoglobulin (IVIg).

Main Methods:

Systematic review of randomized controlled trials (RCTs) sourced from the Cochrane Pregnancy and Childbirth Group's Trials Register.
Included trials focused on women with at least three prior miscarriages and limited live births, excluding non-immunologic causes.
Data extraction and quality assessment were performed independently by multiple reviewers.

Main Results:

Twenty high-quality trials were analyzed, involving various immunotherapies.
Paternal cell immunization (12 trials) showed no significant difference in live births (Peto OR 1.23, 95% CI 0.89–1.70).
Intravenous immunoglobulin (8 trials) also demonstrated no significant benefit (Peto OR 0.98, 95% CI 0.61–1.58). Other methods like third-party donor cells and trophoblast membranes also lacked significant efficacy.

Conclusions:

Current evidence suggests that paternal cell immunization, third-party donor leukocytes, trophoblast membranes, and intravenous immunoglobulin do not offer a significant benefit over placebo for improving live birth rates in women with unexplained recurrent miscarriage.
Further research may be needed, but existing high-quality trials do not support these immunotherapies as effective treatments for this condition.