Ej. Fraser et al., IMMUNIZATION AS THERAPY FOR RECURRENT SPONTANEOUS-ABORTION - A REVIEWAND METAANALYSIS, Obstetrics and gynecology, 82(5), 1993, pp. 854-859
Objective: To determine the efficacy of immunotherapy as treatment for
recurrent spontaneous abortion (three or more consecutive abortions w
ithout an intervening pregnancy of more than 20 weeks' gestation) usin
g meta-analysis. Data sources: The search began with MEDLINE and was s
upplemented by reference lists from original research, review articles
, and textbooks. We also corresponded with investigators and consulted
experts in the field of infertility. Methods of study selection: We i
dentified four randomized controlled trials and 19 case series reports
that examined the use of immunotherapy for recurrent spontaneous abor
tion. Data extraction and synthesis: A meta-analysis performed on four
randomized controlled trials of leukocyte immunotherapy or trophoblas
t membrane infusion revealed a fixed-effects model odds ratio of 1.3 (
95% confidence interval [CI] 0.77-2.3) and a random-effects model odds
ratio of 1.3 (95% CI 0.44-3.8). Conclusion: The quality of evidence r
egarding this treatment is class I (best), and the strength of recomme
ndation is D (fair evidence against its use). Unless its efficacy can
be established through other randomized controlled trials, this treatm
ent should be abandoned.