The Impact of Autoantibodies on IVF Treatment and Outcome: A Systematic Review

Simopoulou, Mara; Sfakianoudis, Konstantinos; Maziotis, Evangelos; Grigoriadis, Sokratis; Giannelou, Polina; Rapani, Anna; Tsioulou, Petroula; Pantou, Agni; Kalampokas, Theodoros; Vlahos, Nikolaos; Pantos, Konstantinos; Koutsilieris, Michael

doi:10.3390/ijms20040892

Cited by 51 publications

(40 citation statements)

References 96 publications

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“…In a recent meta‐analysis, Simopoulou et al observed that patients undergoing IVF with positive ANA showed lower rates of clinical pregnancy and birth along with higher rates of abortion. In the same study, the presence of antithyroid antibodies or antiphospholipid was not associated with a worse treatment outcome …”

Section: Discussionmentioning

confidence: 73%

“…The relationship between autoantibodies, with or without a systemic disease, with infertility and RM is not well established in the literature. Antithyroid antibodies (anti‐thyroglobulin and anti‐thyroperoxidase), antiphospholipid antibodies (anti‐cardiolipin, anti‐β2‐glycoprotein‐I, and lupus anticoagulant), antispermatozoa antibodies, anti‐endomysium, anti‐DNA, and antinuclear antibodies (ANA) are the most studied autoimmune markers, which are related to reproductive problems …”

Section: Introductionmentioning

confidence: 99%

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Antinuclear antibodies and recurrent miscarriage: Systematic review and meta‐analysis

Cavalcante

Sarno

et al. 2019

American J Rep Immunol

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Studies have investigated the relationship between antinuclear antibodies (ANA) and recurrent miscarriage (RM). The objective of this paper is to evaluate the presence of ANA as a risk factor for spontaneous abortion in patients with RM. By considering the guidelines of Preferred Reporting Items for Systematic Reviews and Meta‐Analysis, the authors performed systematic review and meta‐analysis by searching the databases of PubMed/Medline and SCOPUS. Review Manager, Version 5.3 performed the statistical analysis. Binary variables were analyzed by odds ratio (ORs) and 95% confidence interval (CI). The subgroup analysis compared the effect of different ANA titers. The authors analyzed the ANA patterns of immunofluorescence staining. Seven case‐control studies were selected. The frequency of positive ANA was statistically higher in the RM group (20.6%, 288/1400) as compared to the control group (6.7%, 72/1080). The meta‐analysis of the positive ANA showed a statistical difference between the two groups (OR 3.30, 95% CI 1.41‐7.73; I2 = 87%, P = .006). Studies have revealed different frequencies of ANA patterns of immunofluorescence. This meta‐analysis suggested that positive ANA might increase the risk of RM. However, it was not possible to conclude which ANA pattern of immunofluorescence staining is more frequent in the RM group.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Antinuclear antibodies and recurrent miscarriage: Systematic review and meta‐analysis

Cavalcante

Sarno

et al. 2019

American J Rep Immunol

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“…From pathological conditions related to the endocrine system functionality, to systemic autoimmune disorders, and lifestyle/environmental related factors, the pallet of the usual suspects in affecting fertility covers a wide range. In addition, a high prevalence of premature ovarian failure (POF), polycystic ovary syndrome and endometriosis is also observed in several female populations studied all over the word [3,4,5].…”

Section: Introductionmentioning

confidence: 99%

The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization

Pantou¹,

Simopoulou

Sfakianoudis³

et al. 2019

JCM

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The present study aims to explore the effectiveness of laparoscopic surgery on women presenting with infertility, of unidentified aetiology according to the standard infertility investigation, and recurrent failed In Vitro Fertilization (IVF) attempts. Identifying and correcting possible underlying pathologies by laparoscopy may subsequently enable natural conception in an effort to address infertility and avoid IVF overuse. One-hundred and seven (107) women with unidentified aetiology of infertility and recurrent failed IVF attempts met the inclusion criteria. Laparoscopic surgery was performed as the endpoint of the patients’ diagnostic journey, aiming to identify a possible underlying factor as the cause of infertility. Sixty-two (62) out of 107 patients (57.94%) that underwent laparoscopy were diagnosed with endometriosis, 25 out of the 107 patients (23.3%) were diagnosed with periadnixal and pelvic adhesions, and 20 cases (18.69%) presented with no pathology and remained unexplained. Following identification and correction of endometriosis and pelvic adhesions, patients were invited to conceive naturally. For the patients that laparoscopic investigation failed to reveal any pathology they were categorized as unexplained infertility and were subjected to a single IVF cycle. Natural conception success rate within the first postoperative year was the primary outcome. Within the first postoperative year, 30 out of 62 patients (48.38%) diagnosed with endometriosis following laparoscopic investigation achieved a natural conception, and 28 out of them (93.4%) reported live-births. Additionally, 11 out of 25 patients (44%) diagnosed with periadnixal and pelvic adhesions achieved natural conception within the first operative year. Regarding the group of unexplained infertility patients, only four out of the 20 patients (20%) achieved clinical pregnancy in the first post-operative IVF cycle. In conclusion, laparoscopy appears to be a promising approach, addressing infertility, providing significant diagnostic findings, while avoiding IVF overuse regarding patients of unidentified infertility presenting with recurrent failed IVF attempts.

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“…Emphasis has been placed on changes in the thyroid function and the consequences of thyroid disorders during pregnancy in the past decades 16,49. But, to the best of our knowledge, no previous nationwide cohort study has examined the chance of a live birth in women with hyperthyroidism and hypothyroidism, compared to women without thyroid dysfunction undergoing ART treatment 58. However, a number of studies have examined the impact of thyroid dysfunction on ART treatment, based on clinical biomarkers in terms of measured antibodies, follicle counts, TSH levels, and hormone treatment 6,20–22,24–28.…”

Section: Discussionmentioning

confidence: 99%

<p>The chance of a live birth after assisted reproduction in women with thyroid disorders</p>

Jølving

Larsen

Fedder

et al. 2019

CLEP

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Purpose Women with thyroid disorders may have increased infertility and poor reproductive outcomes, but it is unclear if assisted reproductive technology (ART) is effective in this population. The aim of this study was to examine the chance of a pregnancy (biochemical and clinical), and a live birth after ART, in women with thyroid disorders undergoing ART treatment, compared to women without thyroid disorders. Among live-born children, we assessed the risk of congenital malformations. Patients and methods In a nationwide cohort study of all women undergoing ART treatments in Denmark from 1 January 1994 throughout June 2017, we calculated the chance of a pregnancy and a live birth after embryo transfer. Women with thyroid disorders were stratified into two groups: those diagnosed with hypothyroid or hyperthyroid disorders. The adjusted OR (aOR) of a biochemical and a clinical pregnancy, a live born child and a congenital malformation was computed using multilevel logistic regression models. Results In total, 199,674 embryo transfers were included in 2,101 women with thyroid disorders and in 65,526 women without thyroid disorders. The chance of a biochemical pregnancy was significantly reduced in women with hyperthyroidism (aOR=0.80, 95% CI 0.69–0.93), and the aOR of a live birth was 0.86, 95% CI 0.76–0.98. The aOR for a live birth in women with hypothyroidism was 1.03 (95% CI 0.94–1.12). Children of women with hypothyroidism, who were conceived after ART treatment, had a significantly increased risk of any congenital malformation (aOR=1.46 [95% CI 1.07–2.00]). Conclusion Women with hyperthyroidism receiving ART treatment had a decreased chance of a live birth per embryo transfer compared to women without thyroid disorders. Women with hypothyroidism did not have a decreased chance of a live birth but their offspring had an increased risk of congenital malformation.

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The Impact of Autoantibodies on IVF Treatment and Outcome: A Systematic Review

Cited by 51 publications

References 96 publications

Antinuclear antibodies and recurrent miscarriage: Systematic review and meta‐analysis

Antinuclear antibodies and recurrent miscarriage: Systematic review and meta‐analysis

The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization

<p>The chance of a live birth after assisted reproduction in women with thyroid disorders</p>

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