title: Antinuclear antibody reduces the pregnancy rate in the first IVF-ET treatment cycle but not the cumulative pregnancy rate without specific medication.
abstract: OBJECTIVE
  It has been shown that the presence of antinuclear antibody (ANA) might reduce pregnancy rates after in vitro fertilization-embryo transfer (IVF-ET). However, the mechanism of implantation failure by ANA has not yet been clarified. This study was performed to investigate the impact of ANA on pregnancy rates after IVF-ET, and the necessity of specific medication for infertile women who have ANA in their sera.
  
  
  METHODS
  A total of 108 infertile women were treated by IVF-ET or intracytoplasmic sperm injection (ICSI)-ET. ANA was examined by an indirect fluorescent antibody procedure. Data from women under 40 years old were analyzed retrospectively.
  
  
  RESULTS
  The implantation rates per embryo transferred in the first treatment cycles were 14.8% (eight of 54) and 32.4% (33 of 102), in women with and without ANA, respectively. There was a significant difference in the implantation rates between the two groups (P < 0.05). The pregnancy rates per ET in the first treatment cycles were 28% (seven of 25) and 54.2% (26 of 48), respectively. There was also a significant difference in the pregnancy rates between the two groups (P < 0.05). Afterwards, treatments with IVF-ET or ICSI-ET were repeatedly performed for unsuccessful patients, without any specific medication for ANA. The average ET cycles were 1.80 +/- 1.13 and 1.27 +/- 0.54, in women with and without ANA, respectively. The cumulative pregnancy rates per patient were 68% (17 of 25) and 55.6% (35 of 63), respectively. There was no significant difference in the overall pregnancy rates between the two groups.
  
  
  CONCLUSIONS
  These findings suggest that ANA might have an impact on implantation failure in women treated by IVF-ET or ICSI-ET. ANA reduced the pregnancy rates in the first IVF-ET or ICSI-ET cycles but not the cumulative pregnancy rates without medication. This indicates that the mechanisms of implantation failure by ANA could be solved, and effective and safe medication should be developed for better implantation rates, especially in the first treatment cycle.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical School, Kawachi-gun, Tochigi, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shibahara
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hirano
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kohno
authors.forename: Chikako
authors.initials: C
authors.lastname: Hirashima
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suzuki
authors.forename: Satoru
authors.initials: S
authors.lastname: Takamizawa
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D017152:Antibodies, Antiphospholipid / Q000097:blood; D010064:Embryo Implantation / Q000276:immunology; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000276:immunology / Q000628:therapy; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D017211:Treatment Failure
chemical_list: D000974:Antibodies, Antinuclear; D017152:Antibodies, Antiphospholipid; D016682:Lupus Coagulation Inhibitor