title: Lymphocyte immunotherapy in the treatment of recurrent miscarriage: systematic review and meta-analysis.
abstract: OBJECTIVE
  Recurrent miscarriage (RM) affects up to 2-3% of couples of reproductive age. There are several causes for this condition, including immunologic. The embryo is considered an allograft, subject to the rejection mechanisms of the maternal immune system. Immunotherapy involving immunization with lymphocytes is considered in cases of idiopathic RM. However, there is still no consensus regarding the efficacy and safety of this therapy.
  
  
  METHODS
  This systematic review and meta-analysis evaluated the data available in the literature regarding the efficacy and safety of the use of immunotherapy with lymphocytes in couples with history of RM. Searches in PubMed/Medline, SCOPUS, and Cochrane Library databases were conducted, using the following keywords: "recurrent miscarriage," "lymphocyte immunotherapy," and "meta-analysis." Statistical analyses were performed using Review Manager 5.3 (RevMan), version 5.3.
  
  
  RESULTS
  Six published meta-analysis were retrieved; two found no improvements in the rate of live births after the use of immunization with lymphocytes in the treatment of RM, and four found a beneficial effect of the use of immunotherapy with lymphocytes in cases of RM, with significant improvements in the rate of live births.
  
  
  CONCLUSIONS
  Data available in the literature supports the efficacy and safety of immunotherapy with lymphocytes in cases of RM without an identified cause.
authors.affiliation: Department of Gynecology and Obstetrics, University of Fortaleza (UNIFOR), Fortaleza, CE, Brazil.
authors.forename: Marcelo Borges
authors.initials: MB
authors.lastname: Cavalcante
authors.affiliation: Department of Gynecology and Obstetrics, Bahia Federal University (UFBA), Salvador, BA, Brazil.
authors.forename: Manoel
authors.initials: M
authors.lastname: Sarno
authors.affiliation: Department of Obstetrics, Paulista School of Medicine-São Paulo Federal University (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, Brazil. araujojred@terra.com.br.
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: Department of Obstetrics and Gynaecology, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, VIC, Australia.
authors.forename: Fabricio
authors.initials: F
authors.lastname: Da Silva Costa
authors.affiliation: Department of Obstetrics and Gynecology, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Barini
mesh_terms: D000026:Abortion, Habitual / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007114:Immunization; D050498:Live Birth / Q000453:epidemiology; D008214:Lymphocytes / Q000276:immunology*; D011247:Pregnancy
keywords: Lymphocyte immunotherapy; Recurrent miscarriage; Systematic review