Immunotherapy for recurrent miscarriage.
BACKGROUND
Immunologic aberrations might be the cause of recurrent early pregnancy loss in some women.


OBJECTIVE
The objective of this review was to assess the effects of leukocyte immunisation or other immunologic treatments such as intravenous immune globulin (IVIG) on the live birth rate in women with previous unexplained recurrent miscarriages.


METHODS
The Cochrane Pregnancy and Childbirth Group trials register was searched (September 2002). Individual patient data were obtained from the American Society for Reproductive Immunology.


METHODS
Randomised trials of immunotherapy in women with three or more prior miscarriages and no more than one live birth; all recognised non-immunologic causes ruled out and no simultaneous treatment intervention.


METHODS
Eligibility and trial quality were assessed by one reviewer.


RESULTS
Nineteen 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 immunisation (11 trials, 596 women), odds ratio (OR) 1.05, 95% confidence intervals (CI) 0.75 to 1.47; third party donor cell immunization (3 trials, 156 women), OR 1.39, 95% CI 0.68 to 2.82; trophoblast membrane infusion (1 trial, 37 women), OR 0.40, 95% CI 0.11 to 1.45; intravenous immune globulin (IVIG), OR 0.98, 95% CI 0.61 to 1.58.


CONCLUSIONS
Paternal cell immunization, third party donor leukocytes, trophoblast membranes, and intravenous immune globulin provide no significant beneficial effect over placebo in preventing further miscarriages.
Scott
J R
JR
Department of Obstetrics and Gynaecology, University of Utah Medical Centre, 420 Chipeta Way, Suite 100, Salt Lake City, Utah 84108, USA. jscott@hsc.utah.edu
D000026:Abortion, Habitual / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic