Critical analysis of intravenous immunoglobulin therapy for recurrent miscarriage

An alloimmune abnormality is believed to be the cause of recurrent miscarri age in couples in whom no other cause can be identified, Because of its imm unosuppressive properties, intravenous immunoglobulin (IVIG) is used as a t reatment for this disorder, The purpose of this study was to determine whet her MG improves the chance of successful pregnancy in women with recurrent miscarriage by using individual patient data from efficacy trials. Detailed information on each patient enrolled in these trials was obtained to evalu ate the efficacy of IVIG and investigate the effect of clinical variability on pregnancy outcome. Data from 125 patients in the IVIG group and 115 pat ients in the placebo group were available for analysis. Although the number of previous miscarriages and female age were both negative prognostic fact ors for successful outcome, there was no significant improvement in success ful pregnancy or live birth rate with IVIG. Subgroup analyses indicated tha t timing of IVIG administration may be important. The results of the presen t study highlight the importance of stratification for known confounders, s o that the role of MG can be evaluated in more detail. The collective evide nce thus far indicates that IVIG does not have a therapeutic effect that is clinically meaningful.