Incidence of antibodies in women after failure of assisted reproduction.

OBJECTIVES The aim of this study is to determine to what degree antisperm allo-antibodies (ASA), anti-ovarian antibodies (AOA), anti-zona pellucida antibodies (AZPA) and seven anti-phospholipid antibodies (APLA) can explain the failure of assisted reproduction technology (ART) in women. BACKGROUND Among the causes of reproductive failure are allo- and autoimmune reactions of the organism against reproductive tissues and cells. METHODS We examined a sample of 43 selected women aged 27 to 45 after failure of assisted reproduction technology (ART) via intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Sera from these women were tested by ELISA (enzyme-linked immunosorbent assay) (total Ig) for the presence of anti-sperm allo-antibodies (ASA), anti-ovarian antibodies (AOA), anti-zona pellucida antibodies (AZPA) and seven anti-phospholipid antibodies (APLA). RESULTS We found 22 (51 %) patients positive for the examined antibodies. Among patients with positive results were 3 miscarriages, 3 biochemical pregnancies (↑ hCG) and 16 with no evidence of conception. Positive APLA was found in 17 patients. Selected immunological parameters were negative in 21 (49 %) patients, which means that the tested allo- and auto-antibodies did not cause the failure of ART. CONCLUSION This demonstrates that the range of diagnostic tests limits the success of diagnosis and the method of dealing with infertile couples. The use of cardiolipin as a screening test appears to be insufficient, because in our sample it would have caused a 35 % error rate. Investigation of antibodies against seven phospholipids is thus considered to be reasonable and is beneficial for infertility diagnosis (Tab. 2, Ref. 36).