Immunogenetic Studies in Habitual Abortion

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Abstract
EDITORIAL COMMENT: Readers must judge whether their patients with habitual abortion warrant referral for the type of investigation and immunotherapy reported here. These patients are often anxious to explore every avenue to achieve a successful pregnancy. Many techniques are available with convincing and prestigious advocates. The treatment of infertility at its best is one of the marvels of modern scientific medicine — but there is a warning, many (most!) papers on the treatment of infertility lack controls, which makes it difficult to judge reported results. These comments apply to in vitro fertilization and embryo transfer, artificial insemination, tuba1 surgery, cervical ligation, ovulation induction, and immunotherapy. It is commonplace for couples with blocked tubes, anovulation and/or poor seminal quality/quantity to conceive happily, unexpectedly and successfully without treatment!Summary: Recent evidence suggests that immunological factors could play a role in the aetiology of habitual abortion. In this study, 71 couples with habitual abortion (i.e. more than 3 successive abortions) were investigated. Sharing of HLA‐A, B, DR between partners was not found to be significantly increased. Anti‐HLA antibodies in women against their partners' lymphocytes were found in 18.3%. After immunization with 107‐108 lymphocytes obtained from husband or unrelated donor, there was a seroconversion rate cf 61% in those without antibodies initially. This was not dependent on the number of cells injected, source of cells, degree of sharing of HLA antigens or whether the couple were primary aborters (i.e. having had no advanced pregnancy), or secondary aborters. Seven pregnancies have resulted following the immunization procedure so far, 5 occurring in cross‐match positive patients and 2 in cross‐match negative. Growth retarded infants resulted from the pregnancy of 1 primary aborter and 2 secondary aborters.