Antigenic Profile, Prevalence, and Clinical Significance of Antiphospholipid Antibodies in Women Referred for in Vitro Fertilization

Abstract

The aim of this prospective study was to assess the prevalence of antiphospholipid antibodies (aPL) in women who had undergone in vitro fertilization (IVF) and the relationship between aPL and IVF outcome. A total of 101 infertile women with at least three unsuccessful IVF attempts were consecutively included in this study. Samples were collected in the follicular phase of a spontaneous ovarian cycle 2 months after the last ovulation induction treatment. Age-matched healthy fertile women (n = 160) were included as controls. All were evaluated for the presence of lupus anticoagulant (LA), antibodies (IgG, IgA, IgM) to cardiolipin (aCL), beta2-glycoprotein I (abeta2GPI), and phosphatidylethanolamine (aPE). Out of the 101 infertile women, 40 were persistently positive for aPL, showing a prevalence significantly higher than in controls (39.6% versus 5%, P < 0.0001). Among aPL, aPE were found with a significantly higher prevalence compared with LA, aCL, and aP2GPI (67.5% versus 0%, 15%, and 40%, respectively). Interestingly, aPE were found in 70% of the cases in the absence of the other aPL. The predominant isotype of aPL was IgA, in particular for abeta2GPI. Finally, no significant association was found between the presence of aPL and IVF outcome. This prospective study shows aPE as the most prevalent aPL in infertile women and IgA as more common than IgG and IgM. However, our results do not support an association between aPL and IVF outcome.

Live birth pregnancy outcome after first in vitro fertilization treatment in a patient with Systemic Lupus Erythematosus and isolated high positive IgA anti-β2glycoprotein I antibodies: a case report

“…In contrast, another report underlined significantly higher abortion rates and lower delivery rates in aCL-positive women undergoing IVF [15]. Recently, two small studies highlighted the high prevalence of IgA-β2GPI antibodies in the population of women undergoing IVF, but they did not find association between the presence of IgA-β2GPI and the numbers of IVF attempts or IVF outcome [8, 16]. Altogether these data summarized that the presence of aPL and in particular IgA-β2GPI antibodies are not predictive for success or failure of IVF, but should be regarded as a debasing factor for IVF pregnancy outcome.…”

Antiphospholipid Antibodies in Women Undergoing In Vitro Fertilization Treatment: Clinical Value of IgA Anti-β2glycoprotein I Antibodies Determination

“…In particular, Chamley et al have proposed the action of a β 2GPI on trophoblast proliferation as a mechanism of fetal death [14]. In addition, other studies underlined the necessity to search IgA antibodies for β 2GPI in women undergoing IVF [6, 15]. Recently, we emphasize the determination of a β 2GPI IgA in patients with clinical manifestations of antiphospholipid syndrome [16].…”

“…In-house enzyme-linked immunosorbent assays (ELISAs) were used for the determination of aCL (IgM, IgG, and IgA) and a β 2GPI IgA, as previously described [5, 6]. Determination of a β 2GPI (IgM and IgG) was obtained by using Orgentec ELISA kit.…”

Roles of Antiphospholipid Antibodies, Antithyroid Antibodies and Antisperm Antibodies in Female Reproductive Health

“…This suggests that APS does not affect the early process of implantation or maintenance of pregnancy amongst patients receiving assisted reproduction treatment [27]. aPE was reported to be the most prevalent APA in infertile women, with IgA being more common than IgG and IgM [28]. Among APAs, aPE exhibited a significantly higher prevalence compared with LAC, aCL, and anti-β 2 -glycoprotein I.…”

“…Among APAs, aPE exhibited a significantly higher prevalence compared with LAC, aCL, and anti-β 2 -glycoprotein I. Nevertheless, no significant association between the presence of APAs and IVF outcome was found [28]. …”