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Objective  To explore the therapeutic efficacy of intrauterine perfusion of cyclosporin A (CsA) in intractable recurrent spontaneous abortion (RSA) patients with endometrial alloimmune dysfunction.    Methods  This is a randomized controlled trial (RCT) of patients with intractable RSA with endometrial alloimmune disorders. A total of 201 women were enrolled, all of whom had at least 3 serial abortions and endometrial alloimmune dysfunction. Participants were randomly assigned to two groups. The CsA group ( n  = 101) received intrauterine infusion of 250 mg CsA on the 3rd and 7th days after menstruation for 2 menstrual cycles, while the placebo group ( n  = 100) received placebo. The birth of healthy, deformity-free babies was the main study outcome.    Results  In total, 75 (74.26%) women in the CsA group and 59 (59.00%) women in the placebo group gave birth to healthy babies [ P  = 0.01,  OR  = 2.01; 95%  CI  (1.10∼3.65)]. Compared to the placebo group, the CsA group had dramatically lower endometrial CD56 +  cell and CD57 +  cell concentrations at the luteal phase of the second menstrual cycle ( P  < 0.05).    Conclusion  Intrauterine perfusion of CsA was confirmed to be a promising approach for the treatment of intractable alloimmune RSA.

frontiers in physiology

Efficacy of Intrauterine Perfusion of Cyclosporin A for Intractable Recurrent Spontaneous Abortion Patients With Endometrial Alloimmune Disorders: A Randomized Controlled Trial