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Review
. 2025 Jun;54(6):1193-1203.
doi: 10.18502/ijph.v54i6.18897.

Efficacy of Intravenous Immunoglobulin for Patients with Recurrent Miscarriage: A Meta-Analysis

Yan Gao  1 , Limin Peng  1 , Chengkun Yuan  1 , Shanshan Zhang  2
Affiliations
Review

Efficacy of Intravenous Immunoglobulin for Patients with Recurrent Miscarriage: A Meta-Analysis

Yan Gao et al. Iran J Public Health. 2025 Jun.

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.

Keywords: Adverse reactions; Intravenous immunoglobulin; Meta-analysis; Pregnancy outcome; Recurrent miscarriage.

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Conflict of interest statement

Conflict of interest The authors declare that there is no conflict of interests.

Figures

Fig. 1:
Fig. 1:
Flowchart of selection process.
Fig. 2:
Fig. 2:
Summary assessment of bias risk
Fig. 3:
Fig. 3:
FP of meta-analysis for total live birth rate after IVIG therapy of RMC
Fig. 4:
Fig. 4:
FP of meta-analysis for ARs after IVIG therapy of RMC.
See this image and copyright information in PMC

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