The possible role of antiovary antibodies in repeated in vitro fertilization failures.
OBJECTIVE
The study was conducted to investigate the possible role of circulating ovarian autoantibodies (ov-ab) in patients with repeated in vitro fertilization embryo transfer (IVF-ET) failure and to evaluate the effectiveness of immunosuppression treatment in these patients.


METHODS
The study group comprised 80 IVF patients who had five or more failed treatment cycles (mean 10.2; range 7-22). The presence of ov-ab was compared between these women and 1) 50 IVF patients who conceived during the first three treatment cycles; 2) 50 healthy nulligravidae. All participants were seronegative to nonorgan-specific and antithyroid autoantibodies. Patients in the study group who were positive for ov-ab were treated with 10 mg/day prednisone starting 1 month before ovulation induction. Embryo grading was compared in the IVF cycles before and after treatment.


RESULTS
Ov-ab were found in ten patients (12.5%) in the study group, compared to none in the control groups (P = 0.01). Nine of the patients positive for ov-ab were treated with prednisone for their following cycle. A statistically significant improvement in embryo grading was noted. Three patients conceived after treatment (33%), with a take-home baby rate of 22%, compared to only six patients (8.6%) who conceived among the rest of the seronegative study group, with a take-home baby rate of 7.1% (P = 0.05).


CONCLUSIONS
Ov-ab are a possible marker of an autoimmune disorder that may be one of the causes of repeated IVF failures. Immunosuppression treatment may prove efficient in ov-ab seropositive patients with repeated IVF failures by improving embryo grading and pregnancy rate.
Geva
E
E
Sara Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Israel.
Fait
G
G
Lerner-Geva
L
L
Lessing
J B
JB
Swartz
T
T
Wolman
I
I
Daniel
Y
Y
Amit
A
A
D000328:Adult; D000818:Animals; D001323:Autoantibodies / Q000276:immunology*; D004624:Embryo Transfer / Q000379:methods*; D004622:Embryo, Mammalian / Q000166:cytology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D000882:Haplorhini; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D010053:Ovary / Q000276:immunology*; D011241:Prednisone / Q000008:administration & dosage; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome
D001323:Autoantibodies; D011241:Prednisone