Antiphospholipid antibodies in unselected patients with repeated abortion

Balasch, Juan; Font, Josep; L⊙pez-Soto, A.; Cervera, Ricard; Jové, I. C.; Casals, F J; Vanrell, J.A.

doi:10.1093/oxfordjournals.humrep.a137038

Cited by 45 publications

(12 citation statements)

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“…Abnormal autoimmune function has been suggested to impede female fertility (9,10) and to increase the risk of pregnancy loss (6,(17)(18)(19)(20), a risk we strive to reduce via timely diagnosis and treatment (9). Women were, therefore, designated as autoimmune, or not, before data analysis for this study was initiated.…”

Section: Methodsmentioning

confidence: 99%

A pilot study of premature ovarian senescence: II. Different genotype and phenotype for genetic and autoimmune etiologies

Gleicher

Weghofer

Barad

2009

Fertility and Sterility

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Section: Methodsmentioning

confidence: 99%

A pilot study of premature ovarian senescence: II. Different genotype and phenotype for genetic and autoimmune etiologies

Gleicher

Weghofer

Barad

2009

Fertility and Sterility

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“…Among others, we then expanded this finding by demonstrating that lupus anticoagulant was only one sign of a polyclonal activation of autoimmune function [83]. A large number of studies followed, initially primarily concentrating on the association between lupus anticoagulant and a positively charged APA, the so-called anticardiolipin antibody (ACA) [65,[84][85][86]. We, and other investigators, then demonstrated that lupus anticoagulant was closely associated not only with ACA but with a broad array of abnormally elevated APAs and that APA abnormalities did not appear in isolation, but were part of a polyclonal B-cell activation and could also appear in association with organ-specific autoantibody findings [66,[87][88][89][90].…”

Section: Autoimmune-associated Reproductive Failurementioning

confidence: 99%

Female infertility due to abnormal autoimmunity: frequently overlooked and greatly underappreciated. Part I

Gleicher¹,

Weghofer²,

Barad³

2007

Expert Review of Obstetrics & Gynecology

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When the impact of abnormal autoimmune function on female fertility is objectively examined, an unexpectedly large contribution is (auto)immune related. This may be surprising since many authorities have been dismissive of (auto)immune-associated infertility. In this article, we therefore summarize the link between abnormal autoimmune function and female infertility, based on literature searches. Abnormal autoimmune function affects female fertility at numerous levels of the reproductive process. As with autoimmune conditions in general, abnormal autoimmune function affecting fertility is often difficult to diagnose since it frequently presents subclinically, without overt clinical symptoms. It also demonstrates other characteristics of abnormal autoimmunity, such as familial occurrence and genetic predisposition, environmental cofactors contributing to phenotypic expression of genetic risk and cyclicity of occurrence, often characterized by gestational exacerbation patterns. Proven treatments for autoimmune-associated infertility have not been established to date. This fact should, however, not preclude efforts to reach correct diagnoses, since only accurate diagnoses can lead to appropriately conducted clinical trials.Expert Rev. Obstet. Gynecol. 2(4), 453-464 (2007) "Fashions are the only induced epidemics, proving that epidemics can be induced by tradesmen." Bernard Shaw Bernard Shaw's quotation astutely comments on both the fickleness of fashion and the general fickleness of thought. By utilizing epidemics as acronyms for periodic, irrational behavior, he reminds us that fashionable behavior permeates all spheres of life, including, of course, the science of medicine.The thinking on autoimmune abnormalities in reproductive medicine is a good example. A highly popular topic during the 1980s and early 1990s, autoimmunity fell out of fashion by the end of the last decade. Some prominent individuals [1,2] and professional organizations [3] succeeded to a large degree in relegating the concept that abnormal autoimmune function can adversely affect female fertility to the dustbin of undistinguished, and failed, ideas. This article aims to balance an, at times quite opinionated, discourse [2,4]. As this twopart series of articles will demonstrate, abnormal autoimmune function can indeed interfere with successful human reproduction at quite a number of different levels.

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“…In the study by Rai et al [71] aspirin treatment was started after diagnosis of pregnancy. In both studies [71,72], the outcomes in the aspirin-only group were worse than those in other series with the same schedule [56,[58][59][60][61]74].…”

Section: Management Of Obstetric Antiphospholipid Syndromementioning

confidence: 99%

Management of the antiphospholipid syndrome

Espinosa

Cervera

2010

Autoimmun Highlights

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Antiphospholipid syndrome (APS) is characterized by recurrent venous or arterial thromboses, fetal losses and thrombocytopenia in the presence of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies or antibodies directed to various proteins, mainly β 2 glycoprotein I, or all three. There is consensus in treating patients with APS and first venous thrombosis with oral anticoagulation to a target international normalized ratio (INR) of 2.0–3.0. A recent systematic review recommended a target INR of >3.0 in those patients with APS and arterial thrombosis. The approach in women with obstetric manifestations of APS is based on the use of aspirin plus heparin. The best treatment for patients with the catastrophic variant of the APS is a combination of anticoagulation, corticosteroids, and plasma exchange or intravenous immunoglobulins.

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Antiphospholipid antibodies in unselected patients with repeated abortion

Cited by 45 publications

References 0 publications

A pilot study of premature ovarian senescence: II. Different genotype and phenotype for genetic and autoimmune etiologies

A pilot study of premature ovarian senescence: II. Different genotype and phenotype for genetic and autoimmune etiologies

Female infertility due to abnormal autoimmunity: frequently overlooked and greatly underappreciated. Part I

Management of the antiphospholipid syndrome

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