title: Evidence of gonadal and gonadotropin antibodies in women with a suboptimal ovarian response to exogenous gonadotropin.
abstract: Failure to respond to human menopausal gonadotropin (hMG) with adequate ovarian stimulation is associated with a poor prognosis in subsequent cycles in women participating in an in vitro fertilization/embryo transfer program. Sera from 26 menstruating women (mean age 38 +/- 4.3 years) identified as "low responders" with either tubal or male factor infertility, mean baseline FSH values of 11 mIU/mL, and peak serum estradiol levels lower than 300 pg/mL were assessed for specific antibodies to human ovary and gonadotropins. Twenty-five infertile women with tubal or male factor infertility with a good response to hMG served as controls. Ninety-two percent of low responders had antibodies to FSH and 65% had antibodies to LH when assessed by enzyme-linked immunosorbent assay. Similarly, 77% of low responders had ovarian antibodies. No hepatic antibodies were found in the sera of low responders, indicating that the positivity was not a general interaction with cell components. None of the "good responders" had antibodies to gonadotropins or to ovarian or liver tissue. The significant differences in antibodies between the groups supports a possible immunologic cause for low ovarian stimulation response to gonadotropin.
authors.affiliation: Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: W R
authors.initials: WR
authors.lastname: Meyer
authors.forename: G
authors.initials: G
authors.lastname: Lavy
authors.forename: A H
authors.initials: AH
authors.lastname: DeCherney
authors.forename: I
authors.initials: I
authors.lastname: Visintin
authors.forename: K
authors.initials: K
authors.lastname: Economy
authors.forename: J L
authors.initials: JL
authors.lastname: Luborsky
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D007247:Infertility, Female / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D007986:Luteinizing Hormone / Q000097:blood / Q000276:immunology*; D008596:Menotropins / Q000494:pharmacology*; D008875:Middle Aged; D010053:Ovary / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology
chemical_list: D001323:Autoantibodies; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone