Potential alloimmune factors and immunotherapy in recurrent miscarriage.

: It is difficult to determine whether alloimmune factors are responsible for some cases of recurrent miscarriage. No diagnostic tests have been found to be clinically useful. It appears that paternal cell immunization may increase the live birth rate slightly, but the results of large prospective, randomized studies presently being conducted are necessary to confirm this therapeutic effect. Finally, there are few published reports on the neonatal, childhood, or long-term effects of immunotherapy on the offspring. Therefore, we recommend that physicians adopt a cautious approach to the diagnosis and treatment of potential alloimmune RPL. Patients who strongly desire to pursue immunotherapy after appropriate counseling should be referred to a research center with an interest in this area.