Abstract
BACKGROUND: This study aimed to evaluate the efficacy and safety of intravenous immunoglobulin (IVIG) therapy for recurrent miscarriage (RMC) using meta-analysis. METHODS: Literature from Jan 1990 to Feb 2024 was searched in PubMed, etc., using keywords such as "IVIG", "repetitive miscarriage", and "RMC". Two authors independently assessed the literature quality and risk of via Cochrane handbook, and extracted basic information and outcome indicator data. Meta-analysis was performed employing Review Manager 5.3. RESULTS: Eleven studies were involved, comprising 842 patients, of which 391 received IVIG therapy and 451 received placebo treatment. Relative to placebo group, IVIG group had a notably higher overall live birth rate (OR=2.24, 95% CI=1.68~2.98, Z=5.51, P<0.00001) and a greatly lower miscarriage rate (OR=0.46, 95% CI=0.22~0.95, Z=2.09, P=0.04). Subgroup analysis revealed that both primary and secondary RMC patients in IVIG group had markedly higher live birth rates versus placebo group (OR=2.13, 95% CI=1.18~3.83, Z=2.51, P=0.01; OR=1.50, 95% CI=0.98~2.30, Z=1.96, P=0.04). Nevertheless, the adverse reaction (AR) rate in IVIG group was superior to that in placebo group (OR=4.47, 95% CI=1.01~19.81, Z=1.97, P=0.05). CONCLUSION: IVIG can markedly increase the live birth rate, reduce the miscarriage rate, and enhance pregnancy outcomes in patients with RMC. Nevertheless, the rate of ARs with IVIG therapy is relatively high, thus large-scale, multicenter, randomized controlled trials are needed for validation.