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Keywords:

  • Immunotherapy;
  • intravenous immunoglobulin;
  • meta-analysis;
  • recurrent spontaneous abortion

PROBLEM: Published randomized trials of the use of intravenous immunoglobulins (IVIG) as a treatment for recurrent spontaneous abortion (RSA) have produced conflicting results. The purpose of this study was to conduct a systematic review of the current evidence to evaluate the effectiveness of IVIG for RSA.

METHOD OF STUDY: After a thorough search of the literature, four randomized, doubleblind trials comparing IVIG with placebo for treatment of RSA were included in the metaanalysis. Live birth rates for each treatment group were extracted, and the overall odds ratio (OR) and absolute treatment effect for IVIG were calculated.

RESULTS: Two of the trials showed an increase in successful pregnancy outcome with IVIG treatment and two did not. The overall OR was 1.48 (95% CI, 0.84–2.60) in favor of IVIG, with an absolute treatment effect of 10.1% (95% CI, −4.8–24.6). Excluding pregnancy failures with an obvious cause produced statistically significant results, but this approach may be subject to bias.

CONCLUSION: This meta-analysis suggests that IVIG may have a role in the treatment of recurrent abortion, but as yet no conclusive evidence is available.