Intravenous immunoglobulin therapy for recurrent spontaneous abortion: a meta-analysis.

PROBLEM Published randomized trials of the use of intravenous immunoglobulins (IVIG) as a treatment for recurrent spontaneous abortion (RSA) have produced conflicting results. The purpose of this study was to conduct a systematic review of the current evidence to evaluate the effectiveness of IVIG for RSA. METHOD OF STUDY After a thorough search of the literature, four randomized, double-blind trials comparing IVIG with placebo for treatment of RSA were included in the meta-analysis. Live birth rates for each treatment group were extracted, and the overall odds ratio (OR) and absolute treatment effect for IVIG were calculated. RESULTS Two of the trials showed an increase in successful pregnancy outcome with IVIG treatment and two did not. The overall OR was 1.48 (95% CI, 0.84-2.60) in favor of IVIG, with an absolute treatment effect of 10.1% (95% CI, -4.8-24.6). Excluding pregnancy failures with an obvious cause produced statistically significant results, but this approach may be subject to bias. CONCLUSION This meta-analysis suggests that IVIG may have a role in the treatment of recurrent abortion, but as yet no conclusive evidence is available.