Treatment efficacy for idiopathic recurrent pregnancy loss – a systematic review and meta‐analyses

Abstract

The literature does not allow advice on any specific treatment for idiopathic recurrent pregnancy loss, with the exception of progesterone starting from ovulation. We suggest that any treatment for recurrent pregnancy loss should be used within the context of a randomized controlled trial.

Immunologic and rheumatologic causes and treatment of recurrent pregnancy loss: what is the evidence?

“…Additional proposed etiologies include inherited thrombophilia, luteal phase defect, immunologic abnormalities, and sperm DNA fragmentation. Up to half of RPL cases are unexplained (23)(24)(25).…”

Modern management of recurrent miscarriage

“…Glucocorticoid treatment has produced inconsistent results in RM patients and can increase the risk of prematurity, orofacial clefts, gestational diabetes and hypertension . A recent meta‐analysis using strict criteria for defining unexplained RM found no RCTs involving prednisolone . Two recent meta‐analyses of intravenous immunoglobulin (IVIg) use in RM found no evidence of improved live birth rates .…”

“…A recent meta‐analysis using strict criteria for defining unexplained RM found no RCTs involving prednisolone . Two recent meta‐analyses of intravenous immunoglobulin (IVIg) use in RM found no evidence of improved live birth rates . Recent meta‐analyses of allogenic lymphocyte immunotherapy (eg paternal lymphocyte infusion) reported improved live birth rates in the treatment arm .…”

Acetylsalicylic acid does not prevent first‐trimester unexplained recurrent pregnancy loss: A randomized controlled trial

“…It has been argued that ASA prevents placental thromboses . We conducted a systematic search in the Cochrane Library, PubMed and Embase for studies that reported on treatments with ASA for RPL . In couples with at least 3 consecutive miscarriages, ASA is sparsely investigated in randomized clinical trials (RCT) and has mostly been included together with other drugs .…”

“…20 We conducted a systematic search in the Cochrane Library, PubMed and Embase for studies that reported on treatments with ASA for RPL. 21 In couples with at least 3 consecutive miscarriages, ASA is sparsely investigated in randomized clinical trials (RCT) and has mostly been included together with other drugs. 11,22 Only 1 small RCT including 54 patients has compared 50 mg ASA with placebo, resulting in the same live birth rate of 81%.…”