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What do we really know about autoantibody abnormalities and reproductive failure: a critical review
N Gleicher1, D Pratt, A Dudkiewicz
1Center for Human Reproduction, University of Health Science/Chicago Medical School, IL.
Condensation:
The diagnosis and treatment of autoantibody-associated forms of reproductive failure is critically reviewed.
Objective:
To critically evaluate the published literature in reference to autoantibody-associated forms of reproductive failure.
Location:
Medical School-affiliated private Infertility Center.
Materials:
A review of over 200 published papers reflecting on the topic.
Results:
Autoantibody associated reproductive failure, characterized by a decrease in fecundity and an increase in the risk of pregnancy loss, appears established. Autoantibody abnormalities, as routinely detected by standard laboratory assays, are, however, neither immunologically nor biologically specific since cross reactivities between autoantibodies are frequent and a specific autoantibody may cause a biological effect in one but not in another affected individual.
Conclusions:
The evaluation of autoantibody abnormalities in all cases of suspected autoimmune-associated reproductive failure is valuable and will improve clinical care of affected patients. Clinicians need, however, to recognize the limitations of autoantibody testing and have to adjust their clinical management to the degree and quality of autoantibody evaluation available to them in their community.