Effect of sairei-to combined with aspirin and prednisolone on four recurrent reproductive failure women who are positive for anti-phospholipid antibodies.

We treated four pregnancy cases positive for antiphospholipid antibodies (APLs) who had experienced recurrent second trimester fetal or neonatal losses using a Japanese modified Chinese herbal medicine, Sairei-to, low dose aspirin and adrenocorticosteroid hormone. The clinical courses of their new pregnancies in conjunction with the dynamic changes in their APL titers are described in this paper, and the possible efficacy of this treatment is discussed. The concept that autoimmune abnormalities, especially positive APLs, are generative factors for a range of reproductive failures, such as recurrent abortions, intrauterine growth retardation, intrauterine fetal death and preeclampsia, is now attracting a great deal of attention in the fields of reproductive immunology and perinatal medicine (Yasuda et al., 1995). The main mechanisms in the generation of reproductive failures are considered to be direct damage to chorionic villi by APLs during the period of placentation (Rote et al., 1998), as well as the formation of thrombi intervillous spaces (Arakawa et al., 1999). Considering these mechanisms of the reproductive failure generation by APLs, the application of immune suppressive therapy in combination with anti-coagulation therapy should be reconsidered as a treatment option. In this context, we treated four pregnancy cases positive for APLs who had experienced recurrent second trimester fetal or neonatal losses using a Japanese modified Chinese herbal medicine, Sairei-to, low dose aspirin and an adrenocorticosteroid hormone.