Abstract
Around 1 – 3% of all couples who try to have a child are affected by recurrent miscarriage.
According to the WHO, recurrent miscarriage is defined as the occurrence of three
or more consecutive miscarriages up to the 20th week of pregnancy. There are various
causes of recurrent miscarriage; in many cases, the causes remain unclear, with the
result that immunological factors are one of the possible causes discussed. For the
motherʼs immune system, the embryo represents a semi-allogeneic transplant, as half
of the embryoʼs genes are of paternal origin. In place of a conventional immune response,
the embryo induces a secondary protection mechanism, which contributes to the successful
implantation. When performing immunisation with partner lymphocytes, the patient receives
an intradermal injection of her partnerʼs prepared lymphocytes into the volar side
of the forearm in order to induce immunomodulation with a consequently increased rate
of pregnancy and live birth. A prerequisite for this procedure is that all other possible
causes of sterility have been ruled out in advance. Due to the highly heterogeneous
nature of the data, a significant benefit as a result of the immunisation cannot yet
be clearly proven. However, there are signs that the therapy may be effective when
using lymphocytes that have been extracted as short a time beforehand as possible.
Overall, the treatment represents a safe, low-risk procedure. Following a detailed
informative discussion with the couple regarding the chances of success and following
a detailed review of the indication and contraindications, immunisation with partner
lymphocytes can be discussed with the couple on a case-by-case basis – provided that
all other possible causes of sterility have been ruled out in advance.
Key words
miscarriage - immunology - implantation - immunisation - partner lymphocytes
