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Immunotherapy for recurrent miscarriagePorter TF, LaCoursiere Y, Scott JR
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SummaryImmunotherapy for recurrent miscarriageImmunotherapy does not lower the risk of future miscarriage in women who repeatedly miscarry. Recurrent miscarriage is three or more consecutive early miscarriages. One theory is that for some women, this might be caused by an immune system response to the embryo or fetus. Therapies that try to immunize the woman against the 'foreign' cells of a future pregnancy have been tried. Immunotherapies have included white blood cells (leukocytes) from the woman's partner or a donor, products derived from early embryos (trophoblast membranes), or antibodies derived from blood (immunoglobulin). However, the review of trials found that none of these treatments lower the risk of future miscarriage in women who have recurrent miscarriages.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
October 21. 1996 AbstractBackgroundBecause immunological aberrations might be the cause of miscarriage in some women, several immunotherapies have been used to treat women with otherwise unexplained recurrent pregnancy loss. ObjectivesThe objective of this review was to assess the effects of any immunotherapy, including paternal leukocyte immunization and intravenous immune globulin on the live birth rate in women with previous unexplained recurrent miscarriages. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2004, Issue 3), MEDLINE (1966 to September 2004) and EMBASE (1980 to September 2004). Selection criteriaRandomized trials of immunotherapies used to treat women with three or more prior miscarriages and no more than one live birth after, in whom all recognised non-immunologic causes of recurrent miscarriage had been ruled out and no simultaneous treatment was given. Data collection and analysisThe review author and the two co-authors independently extracted data and assessed study quality for all studies considered for this review. Main resultsTwenty trials of high quality were included. The various forms of immunotherapy did not show significant differences between treatment and control groups in terms of subsequent live births: paternal cell immunization (12 trials, 641 women), Peto odds ratio (Peto OR) 1.23, 95% confidence interval (CI) 0.89 to 1.70; third party donor cell immunization (three trials, 156 women), Peto OR 1.39, 95% CI 0.68 to 2.82; trophoblast membrane infusion (one trial, 37 women), Peto OR 0.40, 95% CI 0.11 to 1.45; intravenous immune globulin, Peto OR 0.98, 95% CI 0.61 to 1.58. Authors' conclusionsPaternal cell immunization, third party donor leukocytes, trophoblast membranes, and intravenous immune globulin provide no significant beneficial effect over placebo in improving the live birth rate. |