Anti-phospholipid antibodies do not affect IVF success

Mendoza‐Pinto

et al. 2015

Autoimmune Diseases

Systemic lupus erythematosus (SLE) is a chronic, multisystemic autoimmune disease that occurs predominantly in women of fertile age. The association of SLE and pregnancy, mainly with active disease and especially with nephritis, has poorer pregnancy outcomes, with increased frequency of preeclampsia, fetal loss, prematurity, growth restriction, and newborns small for gestational age. Therefore, SLE pregnancies are considered high risk condition, should be monitored frequently during pregnancy and delivery should occur in a controlled setting. Pregnancy induces dramatic immune and neuroendocrine changes in the maternal body in order to protect the fetus from immunologic attack and these modifications can be affected by SLE. The risk of flares depends on the level of maternal disease activity in the 6–12 months before conception and is higher in women with repeated flares before conception, in those who discontinue useful medications and in women with active glomerulonephritis at conception. It is a challenge to differentiate lupus nephritis from preeclampsia and, in this context, the angiogenic and antiangiogenic cytokines are promising. Prenatal care of pregnant patients with SLE requires close collaboration between rheumatologist and obstetrician. Planning pregnancy is essential to increase the probability of successful pregnancies.

Section: Contraception and Assisted Reproductionmentioning

confidence: 99%

Understanding and Managing Pregnancy in Patients with Lupus

Mendoza‐Pinto

et al. 2015

Autoimmune Diseases

“…In 2008, American Society for Reproductive Medicine (ASRM) announced that there is no association between APA and pregnancy rate or live birth rate after IVF [ 15 ]. They identified 16 literatures in which the pregnancy rate or live birth rate after IVF treatment in APA-negative and APA-positive women were examined.…”

Section: Introductionmentioning

confidence: 99%

Impact of presence of antiphospholipid antibodies onin vitrofertilization outcome

et al. 2018

ObjectiveTo investigate prevalence of antiphospholipid antibody (APA) in Korean infertile women undergoing the first in vitro fertilization (IVF) treatment and to evaluate the influence of APA on the subsequent IVF outcomes.MethodTwo hundred nineteen infertile women who destined the first IVF were prospectively enrolled in 2 infertility centers. Male factor or uterine factor infertility and women with past or current endocrine or immunologic disorders were completely excluded. Plasma concentration of lupus anticoagulant was measured by clot-based method, and anticardiolipin antibody (IgG/IgM), and anti-β2-glycoprotein 1 antibody (IgG/IgM) was measured by enzyme-linked immunosorbent assay method before starting ovarian stimulation for IVF.ResultsAPA was positive in 13 women (5.9%). Lupus anticoagulant was positive in 2 women (0.9%), anticardiolipin antibody was positive in 7 women (3.2%), and anti-β2-glycoprotein 1 antibody was positive in 4 women (1.8%). In 193 women entering embryo transfer, clinical characteristics and stimulation outcomes were comparable between APA-positive (n=12) and APA-negative group (n=181). The clinical pregnancy rate (66.7% vs. 45.9%), ongoing pregnancy rate (58.3% vs. 37.0%), and miscarriage rate (12.5% vs. 19.3%) were all similar between APA-positive and APA-negative group.ConclusionThe prevalence of APA is low in Korean infertile women undergoing the first IVF cycle, and the presence of APA appears to neither decrease their first IVF success nor increase abortion rate.

“…Considerando esto, sumado a la heterogeneidad de los resultados, no es posible concluir que el tratamiento profiláctico en la TH mejore el pronóstico reproductivo de mujeres sometidas a FIV. La Sociedad Americana de Medicina Reproductiva (ASRM) luego de analizar más de 2000 pacientes emitió sus recomendaciones, sugiriendo que no hay indicación de buscar de rutina trombofilias hereditarias previo a una FIV, y que el tratamiento de las mismas no cambia el resultado de la misma 7 .…”

Section: Trombofilia Hereditariaunclassified

Trombofilias, esterilidad, infertilidad y tratamiento de reproducción asistida

Chaquiriand

2021

rumi

Trombofilias, esterilidad, infertilidad y tratamiento de reproducción asistida Thrombophilias, sterility, infertility and assisted reproductive treatment Trombofilias, esterilidade, infertilidade e tratamento reprodutivo assistido Resumen: La esterilidad se define como la no obtención del embarazo luego de un año de relaciones sexuales sin protección en parejas heterosexuales. Puede afectar hasta un 15 a 20% de las parejas en edad reproductiva en algún momento de la vida. Las causas de esterilidad se dividen en: factor masculino, factor femenino, causa mixta y esterilidad sin causa aparente. Se ha planteado que las trombofilias hereditarias y adquiridas, podrían estar involucradas en su etiología; y que las distintas estrategias de tratamiento de éstas (ácido acetil salicílico, heparina de bajo peso molecular, corticoides, hidroxicloroquina, entre otros) podrían mejorar los resultados de las técnicas de reproducción asistida.