Tumor necrosis factor-alpha, a multifunctional T-helper 1 (Th1) cytokine, plays a significant role in placentation and embryonic development. Altered expression of TNF-α has been implicated in adverse pregnancy outcomes such as recurrent pregnancy loss (RPL) and pre-eclampsia (PE). The use of TNF-α inhibitors (TNFi) like Adalimumab (AD) has garnered attention for its ability to traverse the placental barrier, and modulating maternal immune responses during pregnancy. In this article, we have discussed two patients in whom the immunological factors have been identified in otherwise unexplained RPL and how the use of TNFi could be of help to achieve a viable pregnancy.
