Possible Effect of Extended Use of Hormonal Contraception on Increased Levels of Antiphospholipid Antibodies in Infertile Women

Abstract

Purpose: Increased levels of antiphosholipid antibodies (aPLs) are associated with the autoimmune disorder antiphospholipid syndrome (APS) and are known to play a role in infertility. We investigated the possible effect of prolonged use of hormonal contraception (HC) on autoimmunity after discontinuing HC in women with infertility problems. Material and Methods: We analyzed hormonal status including ovulation and the humoral autoimmune response to eight phospholipids detected by ELISA in 1190 infertile women aged 21?46 (mean age: 29.3) years. Results: Long-term HC did not affect ovulation, but in the absence of ovulation HC masked the hormonal disorders. The majority of patients taking HC for more than 10 years with fertility failure had significantly higher levels of aPLs of the IgG isotype against phosphatidylinositol and phosphatidylserine (p?>?0.001) than against ?2-glycoprotein I and annexin V. Discussion: Thus, high levels of aPLs are significant for the anticoagulant treatment before and during pregnancy to prevent pregnancy loss.

The Pathophysiology of The Antiphospholipid Syndrome: A Perspective From The Blood Coagulation System

“…In some cases, more than one infection was associated to the secondary APS. 17 Drugs like chlorpromazine, phenytoin, hydralazine, procainamide, 18 quinidine, ethosuximide, interferon-alpha, amoxicillin, chlorothiazide, oral contraceptives, 19 cysteamine, 20 and propranolol have also been described as inductors of aPLs and the further development of APS. It has been documented that tumor necrosis factor-α (TNF-α) inhibitors may induce the production of aPLs.…”