Anti-endometrial and anti-endothelial auto-antibodies in women with endometriosis

Abstract

The present study investigates the specificity of anti-endometrial antibodies present in serum of women with endometriosis. A two colour indirect immuno-histochemical method was used, so that the antigenic reactivity of endogenous immunoglobulins was blocked and specific anti-endometrial antibodies were readily distinguishable. Serum was collected from women with endometriosis, before and after 6 months of treatment, and from women without the disease. The reactivity of serum with uterine and ectopic endometrium from women with and without the disease was studied. The frequency of anti-endometrial antibodies in the serum of women with endometriosis was higher (P < 0.001) than in control sera. Most antibodies specifically reacted with glands in ectopic and uterine endometrium. Antibody reactivity was strongest with endometrium from control women, compared with uterine and ectopic endometrium from women with endometriosis (P < 0.01). A proportion of sera containing anti-endometrial antibodies also reacted with vascular endothelium. Binding was strongest to vessels in uterine and ectopic endometrium from women with endometriosis compared to endometrium from women without the disease (P < 0.01). The presence of anti-endometrial antibodies was associated with infertility.

Effect of endometriosis on implantation rates when compared to tubal factor in fresh non donor in vitro fertilization cycles

“…Various factors contributing to reduced fertility are impaired utero-tubal transport of sperm[3] due to distorted anatomy, disturbed ovulation,[4] subtle impairment of oocyte and embryo quality,[567] implantation defects[8910] and antiendometrial antibodies. [11]…”

In vitro fertilization is a successful treatment in endometriosis-associated infertility

“…Nonetheless, an association between minimal/mild endometriosis and subfertility also comes from the observation that surgical removal of peritoneal implants increases subsequent spontaneous fertility (2) and IVF results (3). Possible factors contributing to reduced fecundity in minimal/ mild endometriosis are impaired uterotubal transport of sperm (4), disturbed ovulation (5), subtle impairment of oocyte and embryo quality (6)(7)(8), implantation defects (9)(10)(11), antiendometrial antibodies (12), P resistance (13), and an increased risk of recurrent miscarriage (14).…”

Endometriosis‐Associated Infertility: Double Intrauterine Insemination Improves Fecundity in Patients Positive for Antiendometrial Antibodies

“…21 These include retrograde menstruation, coelomic metaplasia theory, lymphatic and blood vessels disseminating endometrial cells, and another theory that cells from bone marrow circulate and differentiate into endometrial tissue. 31 The presence of serum and peritoneal fluid antiendometrial antibodies (AEA) in patients with E has been well described and correlates with surgically verified E. 29,[32][33][34][35][36][37] The gold standard for detection of E, however, is laparoscopic surgery because E is defined anatomically and clinical reports have correlated the appearance of suspected and biopsied E lesions with pathological confirmation of endometrial glands or stroma located outside the uterus. [22][23][24][25] Thus, E is considered by many to be an autoimmune disease, sharing many characteristics with other autoimmune disorders.…”