Does Immunotherapy for Treatment of Reproductive Failure Enhance Live Births?
Article first published online: 16 FEB 2012
© 2012 John Wiley & Sons A/S
American Journal of Reproductive Immunology
Volume 67, Issue 4, pages 296–304, April 2012
How to Cite
- Issue published online: 19 MAR 2012
- Article first published online: 16 FEB 2012
- Manuscript Accepted: 23 JAN 2012
- Manuscript Received: 20 JAN 2012
- intravenous immunoglobulin;
- reproductive failure
Before effective treatment for reproductive failure can be instituted, the cause of the failure must be determined. A search of PubMed was made to identify the published data regarding diagnosis and treatment of reproductive failure. Results were compared with the frequency of antiphospholipid antibodies (APA) in 2995 women with histories of unexplained infertility, recurrent implantation failure, recurrent pregnancy loss, and fertile women. In addition, pregnancy outcomes among 442 women experiencing reproductive failure and elevated NK cell activity after treatment with intravenous immunoglobulin (IVIg) (N = 242) or intralipids (N = 200) were compared. The prevalence of APA was the same among women with the diagnosis of unexplained infertility, recurrent implantation failure, and recurrent miscarriage. Heparin and aspirin are successful in the treatment of elevated APA among women with recurrent miscarriage but not with recurrent implantation failure. IVIg has been successful in the treatment of recurrent miscarriage and recurrent implantation failure among women with elevated APA and/or NK cell activity. When the pregnancy outcomes of women with a history of reproductive failure and elevated NK cell cytotoxicity treated with intralipid were compared with women treated with IVIg, no differences were seen. Immunotherapy for treatment of reproductive failure enhances live birth but only in those women displaying abnormal immunologic risk factors.