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

Abstract

Implantation failure could be related to antiphospholipid antibodies (aPL). We retrospectively analyzed the usefulness of aPL determination in women undergoing IVF. Conventional aPL of the antiphospholipid syndrome, lupus anticoagulant (LA), anticardiolipin antibodies (aCL), anti-β2glycoprotein I (aβ2GPI) antibodies, and IgG and IgM isotypes as well as IgA isotype were analyzed in women presenting with at least two implantation failures after in vitro fertilization (IVF). In a population of 40 IVF patients, a total prevalence of 20% (8/40) of aPL was found, significantly different from that of the control population (100 healthy blood donors, P < 0.0005). Among the panels of aPL tested, aβ2GPI IgA antibodies were the most prevalent (62.5% 5/8), significantly higher in IVF patients (12.5%, 5/40) than in controls (1%, 1/100) (P = 0.01). No difference according to the numbers of IVF attempts and success of embryo implantation was found between aPL positive and negative IVF patients. In contrast, no accomplished pregnancy with full-term live birth was observed in aPL positive IVF patients. Altogether our data led us to propose aPL assessment, in particular aβ2GPI IgA antibodies, in support of IVF treated women. In a perspective way, an early aPL detection could be the basis for defining novel therapeutic strategy.

Unexplained Recurrent Miscarriage and Recurrent Implantation Failure: Is There a Place for Immunomodulation?

“…This result was associated with important heterogeneity across studies and was not confirmed in considering only cohort studies, which could, however, depend on Type II error. Considering IgA isotypes (not actually included in APS Sydney criteria), similar frequency was noted in 2790 patients with recurrent miscarriage/implantation failure vs controls, but in 40 patients undergoing IVF Paulmyer‐Lacroix et al found that only IgA anti‐β2GPI antibodies prevalence was significantly different from controls (5/40; 12.5% vs 1/100; 1%). Nevertheless, as functional effects are determined by the immunoglobulins’ Fc fragment, the clinical significance of such antigen binding assay (Fab fragment binding) need to be determined.…”

Thrombophilia and assisted reproduction technology—any detrimental impact or unnecessary overuse?

“…However, neither the indication for APA screening was mentioned nor the cut-off levels for APA positivity conformed international consensus criteria in these two studies. A third study reporting a positive association between APA and ART outcome included only eight women who tested positive for anticardiolipin antibody after failing two ART cycles and 32 women without anticardiolipin antibodies as controls [26]. While the Sapporo criteria APAs were not found to affect ART outcome, antibeta2 microglobulin IgA antibody positivity (defined as >99th percentile) was found to be detrimental.…”

Correlation Between Immunological Laboratory Status of Omega-3-Fatty-Acid-Supplemented Patients of a German Fertility Centre and Outcome of IVF-Treatment

“…Data published so far on immunoglobulin levels were mostly based on small patient numbers. Fertility patients with antiphospholipid syndrome showed higher concentrations of immunoglobulin G and M [59] as well as immunoglobulin A [60] than patients with normal fertility.…”