Effect of immunotherapy on patients with unexplained recurrent spontaneous abortion

At present, it is generally believed that immune factors account for 60% of unexplained recurrent spontaneous abortion (URSA). The treatments used for URSA depend on immunomodulation for their effects, and paternal immunization, intravenous immunoglobulin, and the use of growth factors such as granulocyte-colony stimulating factor (filgrastim) have been shown to have a beneficial effect on patients with a poor prognosis. However, these treatment schemes and effects remain controversial. This study aimed to evaluate the effect of immunotherapy using lymphocyte active immunotherapy (LAI) on patients with URSA, and to provide evidences for the clinical effect of this treatment.

The detailed data of total 619 patients with URSA were collected and analyzed, of which 465 patients (LAI group) with immunotherapy and 154 patients (control group) without immunotherapy.

After 77.6% of all the patients in LAI group received the immunotherapy, the maternal blocking antibody (BA) was changed from negative to positive. The conversion rate of maternal BA was increased as the increase of active immunization (>4 times, P<0.05). The pregnancy rate of LAI Group was higher than that of the control group (P<0.05), and there were significant differences of live rate and abortion rate (P<0.05). In addition, compared with the natural pregnancy, the live rate was higher, and the abortion rate was lower in in vitro fertilization (IVF) patients after active immunization, although the difference was not significant (P>0.05).

After lymphocyte immunotherapy, most of the patients with unexplained recurrent spontaneous abortion had the positive BA instead of negative BA. Whether the BA was converted or not, the pregnancy rate and live rate were increased, and the abortion rate was decreased after immunotherapy. Therefore, active immunotherapy could improve the pregnancy outcome of the patients with unexplained recurrent abortion.