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HLA frequency, HLA sharing and immunotherapy in the management of recurrent miscarriage
A S Purandare1, D S Smith, P J Wilson
1Wessex Regional Transfusion Centre, Southampton, England.
Objective:
To test couples with three or more consecutive recurrent miscarriages for suitability of the mother for immunization with paternal lymphocytes.
Setting:
Regional transfusion centre, patients referred by local obstetricians.
Patients And Interventions:
Women treated were from 103 couples with > or = 3 consecutive recurrent miscarriages and no more than one live birth. HLA sharing and frequencies were investigated, and contrasted with control data. Patients showed increased sharing versus control (but not in comparison with gene frequencies of the county population). Sixty-eight mothers were finally found suitable and immunized with paternal lymphocytes.
Outcome Measures:
Pregnancy and live births.
Results:
55/68 conceived, with 30 live births resulting; 8/13 additional successes after repeat (booster) immunization.
Conclusions:
This treatment still suffers from the lack of clear criteria for patient selection, and it should be submitted to a prospective controlled double-blind trial.