Background: Recurrent miscarriage (RM), or recurrent pregnancy loss (RPL), is a significant reproductive health issue that affects approximately 2% to 5% of women attempting to conceive. The anti-paternal cytotoxic antibody (APCA) test can serve as an important diagnostic tool for investigating RM. This study aims to review the existing literature on the prevalence and diagnostic utility of APCA testing in women experiencing RM.
Materials and Methods: The search was conducted across online databases, including PubMed, Scopus, Web of Science, CIVILICA, and Google Scholar until March 2024. This review integrates findings from various studies to determine the prevalence and diagnostic effectiveness of APCA in women with RM.
Results: The incidence of positive APCA was detected in 32% of successful pregnancies. However, the detection of APCA was rare before 28 weeks of gestation, which limits its utility as an early diagnostic tool for recurrent miscarriage. For women diagnosed with RM and positive APCA, immunotherapy may serve as a promising treatment option that can significantly enhance live birth rates, increasing from 18.5% to 53.7% post-treatment. While APCA testing can provide insights into miscarriage risk, its reliability is constrained by methodological inconsistencies and demographic variability. To enhance the accuracy and relevance of APCA testing in clinical practice, it is essential to consider individual patient factors such as age, medical history, and genetic background when developing treatment strategies.
Conclusion: While, APCA testing provides valuable insights into immunological factors related to recurrent pregnancy loss (RPL), but its limitations necessitate a cautious approach. Clinicians should integrate APCA results with genetic assessments and environmental considerations to develop a comprehensive diagnostic strategy for better management of RPL.