Intravenous Immunoglobulin G Improves Pregnancy Outcome in Women with Recurrent Pregnancy Losses with Cellular Immune Abnormalities.
OBJECTIVE
We investigated the therapeutic effect of intravenous immunoglobulin (IVIG) in women with recurrent pregnancy loss (RPL).


METHODS
This was a retrospective observational study. Total 189 RPL women who experienced ≥2 miscarriages were enrolled and investigated conventional etiologies, thrombophilia, and cellular immunity. Patients were divided into four groups; known etiology with (Gr1) and without cellular immune abnormality (Gr2), unknown etiology with (Gr3) and without cellular immune abnormality (Gr4). IVIG was administrated from early pregnancy to 30 weeks of gestation to women with cellular immune abnormality (Gr1 + Gr3).


RESULTS
Cellular immune abnormalities (increased level or cytotoxicity of NK cells and Th1/Th2 ratio) were present in 111 of 189 RPL women (58.7%). Live birth rates of women with and without cellular immune abnormality were not different (Gr1 + Gr3, 84.8% versus Gr2 + Gr4, 89.7%). Furthermore, IVIG success rates were the same between Gr1 and Gr3, those who had cellular immune abnormality. Nevertheless lack of an appropriate control in this study, our IVIG outcome demonstrated better live birth rate compared with those of other investigators.


CONCLUSIONS
Treatment modalities stratified by underlying etiologies of RPL may improve pregnancy outcome. Administration of IVIG is likely to have clinical efficacy in RPL women with cellular immune abnormality.
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Sung Ki
SK
Lee
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Jee Yun
JY
Kim
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Ae Ra
AR
Han
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Sung Eun
SE
Hur
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Chul Jung
CJ
Kim
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Tae Hyun
TH
Kim
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Bo Ra
BR
Cho
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Jae Won
JW
Han
Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.
Sae Geul
SG
Han
Seoul Metropolitan Seobuk Hosptial, Seoul, Korea.
Baeg Ju
BJ
Na
Reproductive Medicine, Department of Obstetrics and Gynecology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Joanne
J
Kwak-Kim
D000026:Abortion, Habitual / Q000276:immunology / Q000628:therapy*; D000328:Adult; D003602:Cytotoxicity, Immunologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007111:Immunity, Cellular; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D007160:Immunoproliferative Disorders / Q000150:complications / Q000276:immunology / Q000628:therapy*; D007167:Immunotherapy / Q000379:methods*; D007694:Killer Cells, Natural / Q000276:immunology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous
Cytokine; intravenous immunoglobulin; natural killer cell; pregnancy outcome; recurrent pregnancy loss