ABSTRACT
Does immunotherapy, specifically intravenous immunoglobulin (IVIg), for treatment of reproductive failure enhance live births? The answer to this question has been controversial. The reason for the controversy lies in the problem of patient selection for a particular treatment. A treatment is more likely to work if it is given to those with a physiologic abnormality that the treatment can correct, and, if the treatment in fact corrects it.1 Not all pregnancies fail for the same reason. Causes for recurrent pregnancy loss have included chromosomal, anatomic, hormonal, immunologic, and thrombophilic abnormalities.2 Thus, one cannot use obstetrical history alone to determine whether immunotherapy will be useful. Only patients experiencing reproductive failure with an immunologic cause would be expected to respond to immunotherapy. The following paragraphs will discuss how to identify those individuals most likely to respond to treatment with IVIg, describe published success rates of IVIg therapy, and present alternative treatments to IVIg.
