Lege Artis Medicinae

[IMMUNOLOGICAL ASPECTS OF PREGNANCY FAILURES - NOVEL THERAPEUTIC APPROACHES]

FÜLÖP Vilmos

DECEMBER 19, 2008

Lege Artis Medicinae - 2008;18(12)

[Recurrent miscarriage and failure of in vitro fertilization and embryo transfer affect millions of women annually. It is one of the great problems of the medical community that in as many as 75% of these failures their cause is never established. Considering that recurrent abortions may have several causes including anatomical, morphological, genetic, medical, bacteriological as well as immunological abnormalities it is inevitable to pursue these kinds of examinations and tests. One part of the immunological background can be explained by autoimmune diseases while the other part of it is associated with immunopathological factors. Currently available practical testing batteries that can directly assess immunological background, as well as their importance are covered. Recently developed and mainly immunology based treatments are also described. The results generally show that immunoglobulin products can be used safely in pregnancy. In the author's institute the efficacy of this therapy has been 93.5% in cases of immune-mediated abortion. As an alternative to intravenous immunoglobulin (IVIG) therapies, partner specific platelet suspension can be used only in selected cases with proven immunological background. Therapy monitoring, that is, assessment of the functional efficacy of IVIG is possible by determining FcR blocking antibodies in the maternal serum. Based upon the functional percentage of serum blocking activity the dosage and number of treatments can be changed.]

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