Understanding the immunobiology of pregnancy and applying it to treatment of recurrent pregnancy loss.

Successful mammalian pregnancy depends upon tolerance of a genetically incompatible fetus by the maternal immune system. When tolerance is not achieved pregnancies fail. Repeated pregnancy failures are associated with high emotional and financial cost. To provide a better understanding of an approach to treatment for recurrent pregnancy loss this manuscript presents a review of current concepts of the immunobiology of successful pregnancies and the immunopathophysiology of unsuccessful pregnancies. Based upon information gleaned from these reviews an approach to diagnosis and treatment of recurrent pregnancy loss is presented.