PROBLEM: There is no reliable laboratory test available to diagnose immunol
ogically mediated miscarriages. We investigated the clinical significance o
f maternal anti-paternal leukocyte antibodies by flow cytometry after alloi
METHOD OF STUDY: The flow cytometry crossmatch (FCXM) was performed in 158
patients with a history of three or more unexplained first-trimester miscar
riages without live birth. After negative FCXM patients were immunized, sub
sequent pregnancy outcomes and FCXM results were followed.
RESULTS: Of 112 subsequent pregnancies, 83 of 100 (83.0%) FCXM-positive pat
ients after immunotherapy had successful pregnancy outcomes, whereas seven
of 10 (70.0%) FCXM-negative patients had miscarriages (P = 0.0001). The per
cent live birth ratio was 2.77 (CI, 1.07-7.16; P = 0.0001) for FCXM-positiv
e patients compared to FCXM-negative patients. The calculated predictive va
lue showed that 75.6% of FCXM-negative patients would have subsequent misca
CONCLUSIONS: Positive FCXM is closely associated with successful pregnancy
outcome following immunotherapy. We propose that FCXM might be included in
the routine laboratory tests for the management of recurrent miscarriages.