Various forms of immunotherapy have been introduced
to treat couples suffering from recurrent
unexplained abortions. IVIg is seen to suppress antiphospholipid
antibodies and is the therapy used
when conventional anti-coagulant or immunosuppressive
treatment is ineffective. It has been noted
that the IVIg infusion contains anti-idiotypic antibodies,
which inhibit the binding of anti-phospholipid
antibodies to corresponding antigens and
inactivate idiotype bearing B cells. Alteration of T
cell subsets, modulation of cell mediated responses,
and blockade of the immunoglobulin FcgR on monocytes,
as well as reduction of the NK cytotoxicity have been reported [13]. Down-regulation of CD56+
and CD56+ CD16+ NK cells have been seen in women
treated with IVIg infusion. The infusion is effective in
enhancing the percentage of live births among women
experiencing RSA. Recent data suggest that IVIg
therapy is useful in maintaining pregnancies among
women with a history of RSA who lose karyotypically
normal embryos and who demonstrate elevated
levels of circulating NK cells [11,13].
The application of LIT involves immunizing the
mother with leukocytes from either paternal or
third party origin. The LIT has been implicated
in an attempt to produce a maternal immunoglobulin
effectors believed necessary for pregnancy
maintenance [5,14]. The foundations for LIT is
composed of three suppositions; (a) there is a maternal
immune response to the conceptus that develops
in all pregnancies that must be blocked, (b)
blocking factors develop in all successful pregnancies
and (c) in the absence of blocking antibodies,
rejection of the fetus occurs [5,14].
The rationale for using seminal plasma in treatment
of RSA is provided in the concept that the
mammalian female responds to antigens present
not only on the trophoblast but also in seminal
plasma. The antiphospholipid syndrome, in women
who suffer from RSA, has been successfully treated
using aspirin, heparin, and prednisone or combination
of the three [5–7].
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