{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:25:53Z","timestamp":1753878353025,"version":"3.41.2"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T00:00:00Z","timestamp":1581033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Problem<\/jats:title><jats:p>To determine whether patients with unexplained recurrent pregnancy loss (URPL) can benefit from pre\u2010conception immunotherapy or on the early phase of the first trimester.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of study<\/jats:title><jats:p>The prospective follow\u2010up study which involved pre\u2010conception patients diagnosed with URPL following rigorous etiology screening in the medical center of recurrent pregnancy loss. In this study, pre\u2010conception immunotherapy included lymphocyte immunotherapy (pre\u2010LIT). Post\u2010conception immunotherapy (post\u2010IM) included LIT or intravenous immunoglobulin (IVIG). Patients were recommended to undergo post\u2010IM immediately from human chorionic gonadotrophin (hCG) elevation. Autoimmune antibodies (AIA) and anti\u2010paternal lymphocytotoxic antibodies (APLA) were tested before and after pre\u2010LIT. Favorable outcome was defined as pregnancy over 14\u00a0weeks. Unfavorable outcomes included biochemical pregnancy loss (BPL) and pregnancy loss with clear implantation location (PLCIL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, URPL accounted for 12.9% of recurrent pregnancy loss (217\/1682). Frequency of BPL was significantly lower in patients with post\u2010IM than that without post\u2010IM [2.8% vs 28.2%; adjusted relative risk (aRR), 0.06; 95% confidence interval (CI), 0.01\u20100.24]. There was a significant positive conversion in the AIA induced by pre\u2010LIT (0.0% vs 31.0%). Frequency of PLCIL in patients with positive iatrogenic AIA conversion induced by pre\u2010LIT was higher than that in patients without AIA conversion [30.4% vs 5.8%; aRR, 7.53; 95% CI, 1.31\u201043.34].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pre\u2010LIT of patients with URPL contributed to a positive iatrogenic AIA conversion, which was associated with an increased risk of PLCIL. Post\u2010IM immediately initiated from the time of hCG elevation can reduce the incidence of BPL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13225","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T16:31:06Z","timestamp":1580142666000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The optimal timing of immunotherapy may improve pregnancy outcome in women with unexplained recurrent pregnancy loss: A perspective follow\u2010up study in northeastern China"],"prefix":"10.1111","volume":"83","author":[{"given":"Yue","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Shengjing Hospital of China Medical University Shenyang China"},{"name":"Key Laboratory of Maternal\u2010Fetal Medicine China Medical University Shenyang 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