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.