Recurrent reproductive wastage and immunologic factors.

PROBLEM: The causes of recurrent reproductive wastage are varied and complex. The present study was designed to focus on the role of immunologic factors in cases where other causes were not evident.

METHOD OF STUDY: Over 20 years, more than 1500 couples were evaluated in our clinic because of recurrent spontaneous abortion. Women were tested for anti-phospholipid antibodies and plasma contact proteins of the intrinsic pathway of blood coagulation after endocrine, organic, infectious and genetic etiologies of miscarriages were excluded.

RESULTS

Anti-phosphatidylethanolamine antibodies, anti-annexin antibodies, and factor XII deficiency were more common factors in recurrent spontaneous abortion patients than were anti-cardiolipin antibodies in terms of induction of recurrent pregnancy losses. Paternal leukocyte immunotherapy of patients without such abnormalities was associated with a significantly improved success rate.

CONCLUSIONS

Recurrent reproductive wastage can be minimized by individualized therapy based on comprehensive evaluation of immunologic factors, including several anti-phospholipid antibodies.