Immunotherapy with intravenous immunoglobulin for prevention of recurrent pregnancy loss: European experience.
OBJECTIVE
Due to its strong "immunomodulating" effect in several well established disorders, high-dose intravenous immunoglobulins (IVIG) has been proposed as an alternative for immunotherapy with allogeneic leucocytes in patients with unexplained recurrent spontaneous abortion. This paper is intended to provide an overview on the European experience in this field.


METHODS
Five European pilot studies with a total of 172 patients as well as one controlled double-blind multicenter study including 64 patients were considered. In the latter, 5% human albumin was used as placebo.


RESULTS
Success rates of the pilot studies varied from 68 to 87%. In the German controlled study, a significant specific effect of IVIG could not be verified. However, success rates for both IVIG and albumin were in the same range as for allogeneic leucocytes.


CONCLUSIONS
At present, it is not sufficiently proven that IVIG is an appropriate tool for immunotherapy of recurrent spontaneous abortions. It is suggested that success rates of both IVIG and albumin are due to a placebo effect. However, we cannot exclude that albumin itself provides immunomodulating capacity.
Mueller-Eckhardt
G
G
Klinikum, Justus-Liebig-Universitat Giessen, Germany.
D000026:Abortion, Habitual / Q000276:immunology / Q000517:prevention & control / Q000628:therapy*; D000418:Albumins / Q000008:administration & dosage / Q000276:immunology; D004311:Double-Blind Method; D005060:Europe; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007167:Immunotherapy; D015337:Multicenter Studies as Topic; D010865:Pilot Projects; D010919:Placebos; D011247:Pregnancy; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000418:Albumins; D016756:Immunoglobulins, Intravenous; D010919:Placebos