FERTILITY AMONG WOMEN WITH RECURRENT SPONTANEOUS-ABORTIONS - THE EFFECT OF PATERNAL CELL IMMUNIZATION TREATMENT

PROBLEM: The risk of women whose chief complaint is recurrent spontane ous abortions (RSA) for secondary infertility (infecundability) has no t been evaluated prospectively. The effect of paternal mononuclear cel l immunization on conception rates is unknown. METHOD: Two hundred wom en whose chief complaint was RSA were randomly assigned to be immunize d with paternal mononuclear cells either before or after (up to 6 post menstrual weeks) conception. Fertility rates (both conception and live birth) were evaluated for the group immunized before conception and c ompared to those for the control group, who were not immunized until a fter conception, using life table and multiple logistic regression ana lyses. RESULTS: Prospectively ascertained, age-related conception rate s for nonimmunized RSA controls appeared to be similar to those for ge neral populations. Immunization before pregnancy had no significant ef fect (power +/- 14%) on rates of conception (66% before, 77% after) or time to conceive (median weeks before 19.5, after 27.0). Live birth r ates (before 59%, after 63%) were also similar for both groups (P = 0. 7). CONCLUSION: Women whose only prior complaint was RSA were not at h igh risk for secondary infecundability, and immunization did not alter either conception rates or time to conceive. Postponement of immuniza tion until after conception did not affect live birth rates for women selected for study because they did not have a history of prior infecu ndability or early repeated miscarriages.