Naslov
Immunotherapy and infertility

Autori
Duic, Zeljko ; Singer, Zvonimir ; Podobnik, Mario ; Ciglar, Srećko ; Radic, Vanja ; Leder, Miljenko ; Humar, Ines.

Izvornik
American journal of reproductive immunology (1600-0897) 51 (2004); 479-480

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, ostalo

Ključne riječi
habitual abortion , IVIG, therapy

Sažetak
The aim of this study was to present the results of the treatment and eventually beneficial evidence for therapeutic effect IVIG/didrogesteron in women who had suffered at least three recurrent miscarriages. We also determinated in pregnant women with history of recurrent miscarriages in blood serum levels of Tumor necrosis factor alpha (TNF) and Interleukin 2 (IL2). We wanted to see eventually beneficial influence therapy on serum levels of cytokines (TNF, IL2) Success was defined as pregnancy beyond gestational week 24 and/or de¬livery. Study design: In the period of 1992 to 2003 forty primary aborters enrolled in study to receive infusion humane intra¬venous immunoglobuline (IVIG) or didrogesteron at doses 30 mg per day starting as soon as pregnancy test was positive. IVIG was produced at the Institute of Immunology in Za¬greb, Croatia. In this study, partners with histocompatbility in HLA-D loci were included. Tissue typing was carried out at the Tissue Typing Center, University Hospital Rebro, Zagreb. Before treatment at our hospital all the patients with the possibility of the chromosomal aberrations, genopaties, anatomic, microbiological, endocrinological, environmental factors or autoimmunization as a cause of abortion were excluded. Treatment (IVIG/didrogesteron, bed rest) started after confirmation of pregnancy on the fifth week of pregnancy. First infu¬sion contained 30 grams of IVIG. Fur¬ther five/six doses of 20 grams were infused every third week. Total dose of IVIG was 130/150 grams per case. All pregnancies, except one, were treated at our hospital, but five women gave birth out of our hospital. Didrogesteron, one of synthetic progestational agent in daily doses of 30 mg was taken orally until 12th week of pregnancy.Results: In IVIG group the average age of women was 31, 8 years (range 24-40). Seventeen out of twenty (85% (17/20) pregnant women delivered 19 babies (one triplets). One pre-term at 28 weeks born baby died 3 hour after birth. Three abortions occurred after the first or sec¬ond infusion. Due to obstetrics reasons ten deliveries terminated by caesarean section (58, 82%). Three pregnancies (17, 64%) terminated before 37 gestation weeks. Two babies were born small for gestational age. Three patients developed hypertension disorders in pregnancy. Three women had pre-term labor pain and were treated with infusion of ritodrin. Due to cervical incompetence in 5 cases in second trimester of pregnancy cervical cerclage were performed (29, 41%). Only six patients in IVIG group had side effects at the time of the first infusion and they were: head¬ache, nausea, chills, and elevated body temperature under 38 C, hot flushing, and chill. Side effects disappeared after reducing the speed of infusion.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

POVEZANOST RADA