RECURRENT SPONTANEOUS-ABORTION - HISTOCOMPATIBILITY BETWEEN PARTNERS,RESPONSE TO IMMUNE THERAPY, AND SUBSEQUENT REPRODUCTIVE-PERFORMANCE

PROBLEM: Immunological factors may account for previously unexplained cases of recurrent abortion. METHOD: After screening 76 couples for ca uses of recurrent spontaneous abortion and measuring maternal antipate rnal immunity. 23 primary spontaneous recurrent aborters were immunize d once with their husbands' leukocytes. Testing for antipaternal cytot oxicity was repeated in 21 couples. Seroconversion was significantly l ess frequent in couples who shared more than one human leukocyte antig en [one of five (20%) versus 13 of 16 (81%), P < .02]. RESULTS: Twelve of 16 women (75%) who became pregnant had live children and five of t hose have had a second live child. All 12 women who achieved successfu l pregnancies had become antipaternal cytotoxic antibody-positive afte r immunization. whereas all four patients who had repeat abortions had failed to seroconvert (P < .001). However, this relationship is not n ecessarily causative, as the successful group also tended to have fewe r previous abortions and less human lymphocyte antigen sharing. CONCLU SION: Except for transient illness after immunization, one moderately small for gestational age baby and one premature labor at 32 wk, no co mplications were observed after immunization.