Immuno therapy In Recurrent Spontaneous Abortion: Randomized and Non-Randomized Trials

Abstract

Objective: The present study was conducted to evaluate the efficacy of immunotherapy with husband's lymphocytes in women with recurrent spontaneous abortion (RSA). Methods: A total of 205 women with three or more consecutive abortions were screened for known causes of recurrent spontaneous abortion. Only 105 women were registered for immunotherapy after excluding the women who had one or the other known cause of abortion. 73 women were registered for immunotherapy against husband's lymphocytes. 32 women were registered under double blind randomized trial. These women were negative for antipaternal cytotoxic antibodies against their husband's cells. Success rate of immunotherapy was same in both the groups. Results: Immunotherapy with husband cells in 73 RSA women was carried out in non-randomized trial. Our results show that the success rate was significantly higher (86%) when compared to other groups of the present study i.e. RSA women who declined to enter the trial (33%), dropouts (50%) and antipaternal cytotoxicity negative RSA women (30%). Antipaternal cytotoxic antibodies (APCA) were taken as the measure of immuno-potentiation. Our results indicate that APCA can be taken as a good indicator for selecting patients for immunotherapy and also to measure whether the RSA women is adequately immunized or not. We have also seen the effect of husband's cells in double blind randomized trial group (32 RSA women). The success rate was 85%, which is comparable to non-randomized trial group. Conclusions: Our results indicate the importance of immunotherapy with husband's lymphocytes in RSA women and also show that APCA can be considered as one of the important immuno-potentiating factor.