Immunology: Organ-specific autoantibodies are possible markers for reproductive failure: a prospective study in an in-vitro fertilization--embryo transfer programme

Abstract

This study was conducted to investigate the usefulness of organ-specific autoantibodies as possible markers for reproductive failure. Antithyroid and antiovarian autoantibody concentrations were measured in 78 patients with mechanical or unexplained infertility that were enrolled in an in-vitro fertilization (IVF)/embryo transfer programme with follow-up of the outcome. In all, 16 patients (20.5%) were positive for antithyroid antibodies, nine (11.5%) were positive for antiovarian autoantibodies and two (2.6%) were positive for both autoantibodies. All 23 patients who were positive for either antithyroid or antiovarian autoantibodies, or both, were defined as the study group, and 55 who were negative for autoantibodies were considered as the control group. No statistical difference in the incidence of autoantibodies was found between the patients with mechanical infertility and those with unexplained infertility. No differences were found in the mean number of oocytes retrieved, fertilization rates or mean numbers of transferred embryos between the study and the control groups. The pregnancy rate per cycle was 10.8% (7/65) in the study group, compared with 25.0% (24/96) in the control group (P < 0.05). We conclude that organ-specific autoantibodies such as antithyroid and antiovarian antibodies may serve as possible markers for reproductive failure. Further investigation is required to understand the possible immunopathological mechanism for reproduction failure in patients with organ-specific autoantibodies.

Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing IVF: a meta-analysis

“…From the remaining ten studies included in the systematic review, three were excluded from the metaanalysis on the basis of their retrospective design (15)(16)(17), two because women involved underwent multiple IVF procedures (8,9), and one (18) because Miscarriage risk in TAI and IVF: a meta-analysis Authors did not provide exact numbers of biochemical pregnancy losses in groups; however, they stated that there were four in total and their exclusion did not alter the findings.…”

“…Etiology of infertility was reported to be similar in TAI groups in four studies (9,11,16,33), while three evaluated personal history of miscarriages as an exclusion criterion (9,10,13). Thus, the potential confounding effect of other causes of spontaneous miscarriages could not be neglected.…”

“…Groups were comparable in age in all of the studies but differed in mean thyroid stimulating hormone (TSH) values in two studies (15,17). TSH and free T 4 (FT 4 ) levels were not reported in two studies (9,16). Diversity in the methodology applied to measure thyroid autoantibodies was observed too.…”

“…In five studies, it was clearly stated that first ART procedure was an inclusion criterion, whereas in three studies, no specific statement was provided (8,13,15,18). In two studies, it was clearly reported that only first cycle results were analyzed (12,15), in another two, multiple IVF cycles were reported (8,9), whereas in the rest no relevant information could be retrieved. Groups were comparable in age in all of the studies but differed in mean thyroid stimulating hormone (TSH) values in two studies (15,17).…”

“…Currently, it is not clear whether there is an association between TAI and poor IVF outcome (5,7). Several studies which examined the association between TAI status and miscarriage provided rather controversial results (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), although it appears that 'TAI per se does not alter the implantation of embryo' (19). Moreover, observations regarding TAI and miscarriage risk from the general population could not be applied to an IVF setting and vice versa, since women undergoing IVF are considered as a distinct subgroup, representing a 'special population' (20).…”