IMMUNOTHERAPY WITH INTRAVENOUS IMMUNOGLOBULIN FOR PREVENTION OF RECURRENT PREGNANCY LOSS - EUROPEAN EXPERIENCE

PROBLEM: Due to its strong ''immunomodulating'' effect in several well established disorders, high-dose intravenous immunoglobulins (IVIG) h as been proposed as an alternative for immunotherapy with allogeneic l eucocytes in patients with unexplained recurrent spontaneous abortion. This paper is intended to provide an overview on the European experie nce in this field. METHOD: Five European pilot studies with a total of 172 patients as well as one controlled double-blind multicenter study including 64 patients were considered. In the latter, 5% human albumi n was used as placebo. RESULTS: Success rates of the pilot studies var ied from 68 to 87%. In the German controlled study, a significant spec ific effect of IVIG could not be verified. However, success rates for both IVIG and albumin were in the same range as for allogeneic leucocy tes. CONCLUSION: At present, it is not sufficiently proven that IVIG i s an appropriate tool for immunotherapy of recurrent spontaneous abort ions. It is suggested that success rates of both IVIG and albumin are due to a placebo effect. However, we cannot exclude that albumin itsel f provides immunomodulating capacity.