Short-term therapy for recurrent abortion using intravenous immunoglobulins: results of a double-blind placebo-controlled Italian study

It is still unclear whether i.v. immunoglobulins (Ig) can facilitate thereproductive prognosis of women who have suffered recurrent pregnancy loss.We report the results of a multicentre placebo- controlled study on theeffect of Ig administration on pregnancy outcome in 46 women who hadsuffered at least three recurrent miscarriages. All were screened toexclude chromosomal or Mullerian abnormalities, the presence of antinuclearantibodies, lupus anticoagulant (LA) or elevated titres of anticardiolipinantibodies which may have revealed an underlying autoimmune problem. Toavoid a selection bias towards ongoing pregnancies, i.v. Ig or placebo wereadministered between weeks 5 and 7 of gestation for 2 consecutive days assoon as each woman knew she was pregnant and before embryonic heartactivity could be detected. A further infusion was administered at week 8when ultrasonography confirmed an ongoing embryonic development. In all,68% of the women who received Ig went to term versus 79% of those whoreceived a placebo (not significant), with no significant differences inthe pregnancy course or the perinatal outcome. These results suggest eitherthat women with recurrent miscarriages who have no recognized cause ofpregnancy loss have a good reproductive prognosis without any treatment orthat the emotional care associated with the administration of a placebo canindirectly facilitate the progression of pregnancy.