Literature For and Against Immune Treatments

Posted By Braverman IVF & Reproductive Immunology || 12-Oct-2010

Patients have called me and asked,"Why do other doctors quote literature that says immune treatments don’t work or are dangerous?"

The first thing everyone has to realize is that there is literature on both sides of the argument. In fact, most of the literature today supports the diagnosis and management of immune-related causes of recurrent pregnancy loss (RPL). It’s important to note that most research is from journals around the world because not much inquiry is done on this topic in the United States. Most of the doctors who quote the literature opposed to immune-related treatment do not have any background in immunology and therefore, don’t have the ability to probably read or analyze the data in these studies or detect potential flaws.

A General Problem with Negative Literature & Proponents Of It

Most studies against the use of IVIG or even PLI were and are flawed by many factors. The most significant is the complete lack of understanding of the many cell lines involved in immune tolerance and hence immune rejection. Simply treating anyone with RPL without knowing the reasons you are treating won’t give you any answers as to whether therapy works. Most of the recent literature is starting to address this issue and is looking at a complete immune cell analysis and drawing much better conclusions.

Both Sides Agrees That the Immune System Causes Recurrent Pregnancy Loss!

Certainly there is no argument the immune system is involved in pregnancy loss, and that treatments help many patients avoid miscarriage and IVF failure (just look at our list of patients that have had so many losses, some as many as 18, before we treated them, and you'll understand that the treatments work). Our job is to try and shorten the list of those that need to be treated so patients who don’t need the treatment don’t get it. But as a last option, many patients just can’t ignore the option of these treatments.

Are Treatments FDA Approved?

The second agreement lobbied against PLI is the fact that it is not FDA approved due to a Lancet study in 1998. Again, the world literature is already way beyond this conclusion and has showed the studies here were flawed by improper preparation of the PLI injections and loss through refrigeration of the very important receptors on the cells that were to be injected to help develop immune tolerance. But again, the lack of understanding of immunology by those quoting these studies has guided many away from treatments that are now helping so many patients around the world.

Are Treatments Safe?

Lastly, there is the issue of safety. There is abundant literature showing the safety of IVIG, and large series have shown this treatment to be safe not only in pregnancy but in all other autoimmune syndromes that it has been used to treat. This is consistent with our history of no serious complications in all the years we have been treating patients.

Past Treatments Prove Success

The most important evidence for the success of these immune treatments is the success of our former patients. Seeing, diagnosing, and treating this very complex group of patients, we rely on the great success we have had over the years as the best proof that our diagnosis and treatments are effective. It’s unfortunate that many have begun treating patients for immune related pregnancy loss with limited knowledge of the field, and, as we have stated on this site, these treatments are best left in the hands of those with extensive experience because quality treatment is necessary for success.

Feel free to contact our office to discuss the literature and procedures of these treatments. Our success is no coincidence, and misguided literature should not sway someone from at least exploring and understanding these treatments if they are struggling with RPL. It would have been a shame if all the people we have treated over the years avoided looking into these issues.

Call Braverman IVF & Reproductive Immunology at (516) 584-8710 and discuss the specifics of your situation with our qualified reproductive immunologist.

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