Paternal leucocyte immunotherapy for recurrent pregnancy loss.

ABSTRACT

The defective recognition of foetal alloantigens by the maternal immune system is associated with recurrent pregnancy failure and may be prevented by boosting the maternal immune response with paternal or third party leucocyte immunization. The mechanism by which this process achieves success is not known. Clinical trials on recurrent spontaneous abortion have shown an up to 70% successful pregnancy rate after immunotherapy but the importance of this is unclear because there have been success rates of between 29% and 76% even in the control population. These variations could be due to small sample sizes and heterogeneity in the populations studied as well as co-intervention by the placebo. This article reviews the state-of-the-art for immunotherapy and discusses its mechanism of action in the prevention of recurrent foetal loss.