Oral contraception, circulating immune complexes, antiethinylestradiol antibodies, and thrombosis

Circulating immune complexes were detected in women on oral contraceptives (OC) by a simple antigen nonspecific method using precipitation of serum in 25% saturated ammonium sulfate (CIC-AS). A significant correlation was found between the presence of CIC-AS and the OC vascular risk. A radioimmunoassay with tritiated ethinylestradiol indicated that CIC-AS contained antiethinylestradiol antibodies (anti-EE Ab) in a number of OC users, but indicated also that 1) anti-EE Ab may be found in cases with no detectable CIC-AS, 2) CIC-AS containing no anti-EE Ab are found in nonusers, and 3) even in OC users the CIC-AS may contain antibodies to other ligands than EE. The study demonstrated also that, in OC users with a vascular complication, anti-EE Ab were more frequently detected (78% of cases) than CIC-AS (60%). Moreover, among OC users with CIC-AS, anti-EE Ab were found in 95% of women with a vascular complication and only 37% of current healthy users. The detection of anti-EE Ab appears to be more predictive, with regard to the vascular risk of OC, than the detection of CIC-AS.