REVIEW ARTICLE: Immunological Factors in Pregnancy Wastage: Fact or Fiction
Article first published online: 11 MAR 2008
© 2008 The Author
American Journal of Reproductive Immunology
Volume 59, Issue 4, pages 277–300, April 2008
How to Cite
Clark, D. A. (2008), REVIEW ARTICLE: Immunological Factors in Pregnancy Wastage: Fact or Fiction. American Journal of Reproductive Immunology, 59: 277–300. doi: 10.1111/j.1600-0897.2008.00580.x
- Issue published online: 11 MAR 2008
- Article first published online: 11 MAR 2008
- Submitted December 19, 2007; accepted January 2, 2008.
- intravenous immunoglobulin G;
- spontaneous abortion
Whether maternal immune effector mechanisms with the exception of anti-phospholipid antibodies cause pregnancy loss, and whether effective treatment is possible are subjects of controversy. Hence, in this study the current literature was searched and critically reviewed. In both animals and humans, similar immune effector mechanisms are linked to pregnancy failure. Several levels of evidence indicate that treatments such as aspirin + heparin, intravenous immunoglobulins, corticosteroids, and transfer of allogeneic blood cells bearing paternal antigens may improve the live birth rate. Combination therapy appears promising, but better diagnosis of subgroups responsive to specific therapies is critical. There are fallacies and flaws in the logic of previous arguments against immunological mechanisms and therapeutic interventions. In order to select patients most likely to benefit from known treatments, more extensive immunological testing is required. It is also important to determine the karyotype of all failing embryos.