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

Abstract

Autoantibodies are implicated in various human diseases. In this review, the effects of three different types of autoantibodies (antiphospholipid antibody, antithyroid antibody, and antisperm antibody) on female reproductive health are critically examined. Antiphospholipid antibodies are being detected more frequently in women undergoing in vitro fertilization, but their presence does not appear to influence the outcome of pregnancy, miscarriage, or live birth rates. Available evidence makes it conclusive that antiphospholipid antibodies play negligible roles in recurrent miscarriage. Treatment with aspirin together with low-molecular-weight heparin appears to be effective for recurrent miscarriage. Although antithyroid antibodies are commonly found in women of reproductive age, implantation rates and miscarriage rates are unaffected when women have normal thyroid function. Women with thyroid dysfunction should be treated with <smlcap>L</smlcap>-thyroxine before conception or at early gestational stages to avoid pregnancy complications. Antisperm antibodies are uncommon but are most often associated with ovarian hypofunction. They are believed to cause fertilization failure when found at high titers in seminal plasma, or in the mucosal immune system of women. Intrauterine artificial insemination and in vitro fertilization/embryo transfer are effective treatment modalities for antisperm antibody-related infertility, although this remains a controversial topic in the field of female infertility.

Successful Pregnancy Outcome in Women with Recurrent IVF Failure and Anti-hCG Autoimmunity: A Report of Three Cases

“…It has been proposed that reduced fecundity might be associated with the dysregulation of immune system reactions resulting in enhancement of autoantibody production. Increased prevalence of various types of allo- and autoantibodies (antiphospholipid, antithyroid, antisperm, antiovarian, anti-zona pellucida, anti-trophoblast, antinuclear, anti-smooth muscle, anti-endometrial antibodies) were detected in patients experiencing RIF [2–4]. Other immunological parameters such as elevated numbers of peripheral blood natural killer (NK) cells, immunological defects at the T-cell level, altered levels of cytokines, and the presence of specific maternal HLA-G polymorphisms might as well be associated with implantation failure [3, 7, 8].…”

“…The link between recurrent pregnancy loss, unexplained infertility, and autoimmune disorders was first noticed by Gleicher et al (1989) [1]. Since then, many papers have been published on the association of reproductive failure in clinically asymptomatic patients and allo- and autoantibody positivity against different reproductive tissues and cells [2–4]. …”

The association between subclinical hypothyroidism and TPOAb positivity with infertility in a population-based study: Tehran thyroid study (TTS)

“…Although the uterus and ovary in females and gonadal steroids, testosterone level,spermatogenic function in males can be targeted by thyroid antibodies, there is no consensus regarding the exact mechanism of infertility influenced by thyroid autoimmunity [7,8]. The results of available studies on the association between TAI and infertility are rare and controversial especially in males and are limited by study designs, small sample size, heterogeneity in participants and lack of complete sociodemographic data [9][10][11][12]. Additionally, there are few population-based studies to reveal this association [13].…”

Role of Antisperm Antibodies in Infertility, Pregnancy, and Potential for Contraceptive and Antifertility Vaccine Designs: Research Progress and Pioneering Vision

“…Several investigations have been undertaken to elucidate the direct/indirect relationship between the presence of ASAs and the subsequent pregnancy rate in females, but the results have been inconsistent, especially when advanced assisted reproductive techniques were involved. Although, in males, ASAs were directly associated with male infertility, the overall effect of ASAs on reproductive efficiency in females is yet to be explored, even though reports indicate a reduction in spontaneous pregnancies [150,151].…”