title: Antibodies to beta2 glycoprotein I are associated with in vitro fertilization implantation failure as well as recurrent miscarriage: results of a prevalence study.
abstract: OBJECTIVE
  To investigate whether antiphospholipid and related autoantibodies are associated with IVF implantation failure as well as with recurrent spontaneous miscarriage.
  
  
  METHODS
  Prevalence study.
  
  
  METHODS
  University teaching hospital and associated IVF unit.
  
  
  METHODS
  Patients with at least three consecutive first-trimester miscarriages (n = 97), patients undergoing IVF who had at least 10 embryos transferred without any resulting clinical pregnancy (n = 105), fertile women (n = 106), and patients newly referred for IVF treatment (n = 52).
  
  
  METHODS
  Antibodies tested included lupus anticoagulant; immunoglobulin (Ig) G and IgM isotypes of each of anticardiolipin antibody, antiphosphatidylserine, antiphosphatidylethanolamine, and antiphosphatidylinositol; beta2 glycoprotein I antibodies; and antinuclear antibodies. Statistical analysis included chi2 and Fisher's exact tests for differences between groups, and multiple linear regression analysis and Spearman's nonparametric tests for relations between results.
  
  
  METHODS
  Seropositivity for autoantibodies tested.
  
  
  RESULTS
  Overall, 84 (23%) of the 360 samples tested positive for at least one autoantibody. Beta2 glycoprotein I IgM antibody and antinuclear antibody were significantly associated with both IVF implantation failure and recurrent miscarriage.
  
  
  CONCLUSIONS
  Autoantibodies, particularly beta2 glycoprotein I antibodies and antinuclear antibodies, are associated with IVF implantation failure as well as with recurrent spontaneous abortion, although the mechanism is still unclear. The high seroprevalence of antibodies to beta2 glycoprotein I suggests that it may have an important role in autoimmune reproductive failure that needs to be explored further.
authors.affiliation: Royal Women's Hospital, Melbourne, Victoria, Australia. sternc@cryptic.rch.unimelb.edu.au
authors.forename: C
authors.initials: C
authors.lastname: Stern
authors.forename: L
authors.initials: L
authors.lastname: Chamley
authors.forename: L
authors.initials: L
authors.lastname: Hale
authors.forename: M
authors.initials: M
authors.lastname: Kloss
authors.forename: A
authors.initials: A
authors.lastname: Speirs
authors.forename: H W
authors.initials: HW
authors.lastname: Baker
mesh_terms: D000026:Abortion, Habitual / Q000453:epidemiology / Q000276:immunology*; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D010064:Embryo Implantation / Q000276:immunology*; D005260:Female; D005307:Fertilization in Vitro; D006023:Glycoproteins / Q000276:immunology*; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D017211:Treatment Failure; D053482:beta 2-Glycoprotein I
chemical_list: D001323:Autoantibodies; D006023:Glycoproteins; D053482:beta 2-Glycoprotein I