Antiphospholipid antibodies and human reproductive failure

Area of Science:

• Reproductive Immunology
• Obstetrics and Gynecology
• Autoimmunity

Background:

• Antiphospholipid antibodies (aPL), including lupus anticoagulant (LA) and anticardiolipin antibodies (aCL), are implicated in various pregnancy complications.
• The role of aPL in infertility and recurrent pregnancy loss requires further clarification.

Purpose of the Study:

• To investigate the prevalence of aPL in women with infertility, recurrent spontaneous abortion, and repeated IVF failure.
• To assess the association between aPL and these reproductive outcomes.

Main Methods:

• Screening of 1273 women (<45 years) for aPL, including 822 experimental subjects (infertile, recurrent aborters, IVF failure) and 451 controls.
• Comparison of aPL positivity rates across different study and control groups.
• Evaluation of treatment outcomes (live birth rates) in recurrent aborters with aPL.

Main Results:

• aPL positivity was significantly higher in recurrent aborters (9.2%) and patients with repeated IVF failure (10%) compared to controls.
• aPL was identified as an etiological factor in 12% of unexplained recurrent abortions.
• Seven infertile patients with aPL achieved successful pregnancies without immunotherapy.
• Low-dose aspirin treatment significantly increased live birth rates in recurrent aborters with aPL.

Conclusions:

• Circulating aPL are associated with recurrent abortion and may play a role in IVF implantation failure.
• The presence of aPL is not significantly associated with infertility.
• Low-dose aspirin is a potentially effective treatment for recurrent aborters with aPL.