2025 American Society for Reproductive Immunology Guidelines for the Treatment of Recurrent Pregnancy Losses: Practice Recommendations From the ASRI Clinical Reproductive Immunology Fellowship

ABSTRACT Various immunomodulatory treatments have been applied to women with recurrent pregnancy losses since a significant proportion of them have cellular and autoimmune abnormalities. However, immunomodulatory treatments are often considered controversial for their efficacies. Often, they are provided to unselected patients without investigating potential etiologies by healthcare providers without appropriate reproductive immunology training and qualifications. To eliminate these concerns, the American Society for Reproductive Immunology (ASRI) established the Clinical Reproductive Immunology Fellowship and has been certifying reproductive immunologists. The approach to RPL from a reproductive immunology perspective requires a detailed understanding of underlying immunopathology, advanced knowledge of clinical and basic science and translational research, and the capability to evaluate the available evidence. The immunotherapy guideline development group, composed of clinical reproductive immunology fellows, ASRI, reviewed the currently available data and developed the clinical guidelines for immunotherapy.