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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(03): 260-273
DOI: 10.1055/s-0044-101609
GebFra Science
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Active Immunisation with Partner Lymphocytes in Female Patients Who Want to Become Pregnant – Current Status

Article in several languages: English | deutsch
Veronika Günther
1   Klinik für Gynäkologie und Geburtshilfe, UKSH Campus Kiel, Kiel, Germany
,
Ibrahim Alkatout
1   Klinik für Gynäkologie und Geburtshilfe, UKSH Campus Kiel, Kiel, Germany
,
Wiebe Junkers
2   Universitäres Kinderwunschzentrum, MVZ, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
,
Nicolai Maass
1   Klinik für Gynäkologie und Geburtshilfe, UKSH Campus Kiel, Kiel, Germany
,
Malte Ziemann
3   Institut für Transfusionsmedizin, UKSH Campus Kiel, Kiel, Germany
4   Institut für Transfusionsmedizin, UKSH Campus Lübeck, Lübeck, Germany
,
Siegfried Görg
3   Institut für Transfusionsmedizin, UKSH Campus Kiel, Kiel, Germany
4   Institut für Transfusionsmedizin, UKSH Campus Lübeck, Lübeck, Germany
,
Sören von Otte
2   Universitäres Kinderwunschzentrum, MVZ, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
› Author Affiliations
Further Information

Publication History

received 16 November 2017
revised 30 December 2017

accepted 24 January 2018

Publication Date:
21 March 2018 (online)

Also available at
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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
 

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