Intravenous immunoglobulin (IVIG) therapy for immunologic abortion

Recurrent pregnancy loss associated with immunologic abnormalities has been termed immunologic abortion. Immunologic abortion occurs primarily in women over the age of 30 years and may affect either natural or in-vitro fertilization (IVF)-induced pregnancy. In this article, we review the humoral and cellular immunologic abnormalities that have been associated with this form of recurrent abortion, and we discuss treatment options for women with this disorder. In particular, we have focused on intravenous immunoglobulin (IVIG) treatment for immunologic abortion. We analyzed 14 studies of IVIG therapy for recurrent loss of natural or IVF-induced pregnancies. Factors associated with successful use of IVIG were: (a) Older mean patient age; (b) inclusion of women with immunologic abnormalities; (c) initiation of IVIG therapy prior to conception; and (d) repeated administration of IVIG at physiologic intervals during pregnancy. When used according to these parameters, IVIG therapy is safe and effective for women with immunologic abortion. Appropriate patient selection and rational timing of IVIG administration are crucial factors that determine the success of this treatment. © 2002 Elsevier Science Inc. All rights reserved.