title: Anti-FSH antibodies associate with poor outcome of ovarian stimulation in IVF.
abstract: FSH is required for spontaneous folliculogenesis and is widely used in ovarian stimulation in IVF. Previously, increased concentrations of antibodies against FSH (anti-FSH) have been demonstrated in infertile women. This study aimed to: (i) assess the possible association of anti-FSH with an adverse outcome of IVF with regard to clinical parameters characterizing the ovarian reserve; and (ii) compare serum and follicular fluid (FF) anti-FSH concentrations in relation to follicle size and endocrine markers. IVF patients (n = 182) subjected to gonadotrophin-releasing hormone-antagonist protocol were assessed for anti-FSH using enzyme-linked immunosorbent assay. Increased concentrations of serum anti-FSH immunoglobulin (Ig)G and IgA were associated with impaired ovarian stimulation outcome, with cut-off values <1.0 arbitrary units predicting poor ovarian response (<or=3 oocytes) (adjusted odds ratio for IgG = 6.95, P = 0.005 and IgA = 3.60, P = 0.039). FF anti-FSH IgG and IgA were positively associated with serum anti-FSH concentrations and FSH concentration in FF. Additionally, FF anti-FSH IgG increased with follicle growth (linear regression coefficient = 0.02, P = 0.022). Collectively, these data suggest that serum anti-FSH antibodies are associated with poor ovarian response to FSH stimulation in IVF, with anti-FSH IgA and IgG potentially exerting a local FSH antagonizing effect in maturing follicles.
authors.affiliation: Department of Immunology, Institute of General and Molecular Pathology, Centre of Molecular and Clinical Medicine, University of Tartu, Ravila Str. 19, Tartu 50411, Estonia. kadri.haller@ut.ee
authors.forename: Kadri
authors.initials: K
authors.lastname: Haller
authors.forename: Andres
authors.initials: A
authors.lastname: Salumets
authors.forename: Raivo
authors.initials: R
authors.lastname: Uibo
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility / Q000502:physiology; D005640:Follicle Stimulating Hormone / Q000276:immunology*; D015571:Follicular Fluid / Q000276:immunology*; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000097:blood*; D006080:Ovarian Follicle / Q000502:physiology*; D010062:Ovulation Induction; D017211:Treatment Failure
chemical_list: D007132:Immunoglobulin Isotypes; D005640:Follicle Stimulating Hormone