Recurrent Pregnancy Loss and Cytokines: Not as Simple as It Seems

Recurrent pregnancy loss is a particularly vexing problem. The patient desperately wants to achieve a successful pregnancy and is frustrated by her seeming inability to accomplish a life goal often taken for granted. The physician feels stymied because an identifiable cause can be found in only about 50% of women with recurrent pregnancy loss. Because of the unique immunologic state of pregnancy and similarities to allogeneic transplantation, putative immunologic causes have been attributed to recurrent pregnancy loss. In other words, If we don't understand it, it must be immunologic. Consequently, a number of diagnostic tests and immunologic treatments have been tried with limited success. Currently the most widely used immunotherapy for recurrent pregnancy loss is injecting the patient with white blood cells obtained from the potential father. The rationale for this immunotherapy was derived from studies of kidney transplant patients, who were less likely to reject renal allografts.