Histocompatibility antigen studies in women with recurrent miscarriages and Müllerian uterine anomalies

Objective. To determine whether the HLA alleles DR1, DR3, DR4 and DR10 which have been suggested to be risk markers for unexplained recurrent miscarriages also play a part in women with recurrent miscarriages with Müllerian uterine fusion anomalies. Study design. HLA-DR typing was undertaken in 28 women with recurrent miscarriage who had been surgically treated for Müllerian anomalies and in 360 controls. In the study group, outcome of pregnancies after surgery was correlated to the results of the HLA typing. Results. In the study group, 61% were positive for HLA-DR1, -DR3, -DR4 or -DR10 compared with 65% of the controls (not significantly different). Among patients positive for these HLA risk markers, 64% of the pregnancies after surgery miscarried compared with 13% in those negative (P<0.005, RR for miscarriage=4.8, 95% CI=1.3–18.0). Conclusion. The proposed risk HLA markers for unexplained recurrent miscarriage also seem to display a negative impact on pregnancy outcome in patients with recurrent miscarriages with Müllerian uterine anomalies