Immunogenetics Laboratory, INIGEM, CONICET-UBA, Hospital de Clínicas, University of Buenos Aires, Argentina.
Department of Microbiology, Parasitology and Immunology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Am J Reprod Immunol. 2021 Aug;86(2):e13422. doi: 10.1111/aji.13422. Epub 2021 Jun 3.
Analyze the effect of paternal immunotherapy treatment (PIT) in primary and secondary unexplained recurrent spontaneous abortion (URSA) and unexplained infertility (UI).
A retrospective study analyzed a two-year follow-up between the generation of MLR-Bfs after PIT treatment (or controls first consultation) and a live birth. Recruited patients included primary URSA with two or more miscarriages at <12 weeks gestation, secondary URSA with previous live birth before two or more miscarriages, and UI with inability to conceive after 2 years of regular unprotected intercourse or in vitro fertilizations (IVF). PIT treated were compared with untreated controls.
Primary URSA: live birth was 241/416 (58%) versus 64/282 (23%) controls (p < .0001). Up to age 35, success was 158/217 (73%) and 37/144 (26%) controls (p < .0001). With 3 or more previous URSA, success was 90/135 (67%) versus 17/79 (22%) controls (p < .0001). Between ages 36 and 40, success was 69/147(47%) versus 22/98 (22%) controls (p < .0003), with 3 or more previous URSA live birth was 45/95 (47%) versus 6/46 (13%) controls (p < .0001). In UI, live birth was 99/298 (33%) versus 54/263 (21%) in controls (p < .0009) that increased under age 35 to 53/116 (46%) in treated versus 26/101 (26%) controls (p < .0056). In PIT treated, IVF success required a median of 1 (1.37 ± 0.67) versus a median of 3 IVF procedures (2.75 ± 0.84) in controls.
PIT is a successful treatment for primary and secondary URSA, and UI. PIT reduced the number of IVF required for achieving pregnancy.
分析父系免疫疗法治疗（PIT）对原发性和继发性不明原因复发性自然流产（URSA）和不明原因不孕（UI）的影响。
本研究为回顾性研究，对 PIT 治疗后（或对照组首次就诊）MLR-Bfs 产生后的两年内进行随访，以活产为终点。入组患者包括原发性 URSA，妊娠 12 周前发生两次或更多次流产；继发性 URSA，既往有两次或更多次流产前的活产；UI，2 年规律未避孕性生活或体外受精（IVF）后仍无法受孕。将 PIT 治疗组与未治疗对照组进行比较。
原发性 URSA：活产率为 241/416（58%）vs 64/282（23%）对照组（p<0.0001）。在 35 岁以下，成功率为 158/217（73%）vs 37/144（26%）对照组（p<0.0001）。对于 3 次或更多次原发性 URSA，成功率为 90/135（67%）vs 17/79（22%）对照组（p<0.0001）。36-40 岁时，成功率为 69/147（47%）vs 22/98（22%）对照组（p<0.0003），对于 3 次或更多次原发性 URSA，活产率为 45/95（47%）vs 6/46（13%）对照组（p<0.0001）。在 UI 中，活产率为 99/298（33%）vs 54/263（21%）对照组（p<0.0009），在 35 岁以下时，治疗组的活产率为 53/116（46%）vs 对照组的 26/101（26%）（p<0.0056）。在 PIT 治疗组中，IVF 成功所需的中位数为 1（1.37±0.67）次，而对照组为中位数 3 次（2.75±0.84）。
PIT 是治疗原发性和继发性 URSA 和 UI 的有效方法。PIT 降低了实现妊娠所需的 IVF 次数。
