Carp H J, Toder V, Mashiach S, Rabinovici J
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
Am J Reprod Immunol. 1994 Mar-Apr;31(2-3):112-5. doi: 10.1111/j.1600-0897.1994.tb00855.x.
It is unclear how paternal leukocyte immunization prevents pregnancy loss. We investigated whether immunization affects early pregnancy, and whether it increases the rate of implantation and early embryonic development at the time of implantation.
Three groups of women with possible implantation failure were immunized: (1) recurrent biochemical pregnancies (> 3), (2) three or more failed in vitro fertilization (IVF) cycles, and (3) IVF after immunization for recurrent abortion (> 3). Patients were immunized if antipaternal complement-dependent antibody (APCA) was negative, and mixed lymphocyte culture hyporeactive to husbands lymphocytes. Immunizations were prepared from 100 ml paternal blood separated by Ficoll Hypaque density centrifugation. IVF was attempted after APCA was produced.
In the women with biochemical pregnancies, 10 to 12 subsequent pregnancies developed normally. Seventy-nine subsequent IVF cycles in 33 patients resulted in 20 pregnancies, 16 of which developed normally. Six pregnancies followed 30 cycles in recurrent failed IVF, and 14 pregnancies from 49 cycles in 23 patients with previous habitual abortion.
This treatment may prevent further biochemical pregnancies if control studies confirm this preliminary observation, but was not shown to affect recurrent failed embryo transfer.
尚不清楚父方白细胞免疫接种如何预防流产。我们研究了免疫接种是否会影响早期妊娠，以及在着床时是否会提高着床率和早期胚胎发育率。
对三组可能存在着床失败的女性进行免疫接种：（1）反复生化妊娠（>3次），（2）三次或更多次体外受精（IVF）周期失败，（3）因反复流产（>3次）免疫接种后进行IVF。如果抗父方补体依赖性抗体（APCA）呈阴性且混合淋巴细胞培养对丈夫淋巴细胞反应低下，则对患者进行免疫接种。免疫制剂由通过Ficoll Hypaque密度离心法分离的100ml父方血液制备而成。在产生APCA后尝试进行IVF。
在有生化妊娠的女性中，随后的10至12次妊娠均正常发育。33例患者随后的79个IVF周期中有20例妊娠，其中16例正常发育。反复IVF失败的30个周期后有6例妊娠，23例既往习惯性流产患者的49个周期中有14例妊娠。
如果对照研究证实这一初步观察结果，这种治疗可能会预防进一步的生化妊娠，但未显示对反复失败的胚胎移植有影响。
