title: Autoantibodies and gastrointestinal symptoms in infertile women in relation to in vitro fertilization.
abstract: BACKGROUND
  Prior reports suggest a link between gonadotropin-releasing hormone (GnRH) and gastrointestinal function. The aim of the study was to prospectively investigate women subjected to in vitro fertilization (IVF) using the GnRH analog buserelin, taking into account gastrointestinal symptoms and antibody development against buserelin, GnRH, luteinizing hormone (LH), and their receptors.
  
  
  METHODS
  Gastrointestinal symptoms were registered by the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) before and after IVF treatment, and five years later. Health-related quality of life was evaluated by the 36-item Short-Form questionnaire (SF-36). ELISA was used for antibody analyses before and after treatment. Data were compared with women from the general population.
  
  
  RESULTS
  In total, 124 patients were investigated before and after IVF, and 62 were re-evaluated after five years. Buserelin treatment led to significant impairment of constipation (p = 0.004), nausea and vomiting (p = 0.035), psychological well-being (p = 0.000), and the intestinal symptoms' influence on daily life (p = 0.027). At 5-year follow-up, abdominal pain was worsened (p = 0.041), but psychological well-being was improved (p = 0.036), compared to prior treatment, and 15% had an observable deterioration in gastrointestinal symptoms. None developed severe dysmotility. Patients had higher prevalence of IgG antibodies against LH (p = 0.001) and its receptor (p = 0.016), and IgM antibodies against the GnRH receptor (p = 0.001) prior treatment compared with controls, but no antibody development was observed after IVF.
  
  
  CONCLUSIONS
  Patients experience gastrointestinal symptoms during buserelin treatment, and abdominal pain is still increased after five years, but buserelin does not increase antibody formation against GnRH, LH or their receptors.
authors.forename: Oskar
authors.initials: O
authors.lastname: Hammar
authors.forename: Bodil
authors.initials: B
authors.lastname: Roth
authors.forename: Mariette
authors.initials: M
authors.lastname: Bengtsson
authors.forename: Thomas
authors.initials: T
authors.lastname: Mandl
authors.affiliation: Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden. bodil.ohlsson@med.lu.se.
authors.forename: Bodil
authors.initials: B
authors.lastname: Ohlsson
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D002064:Buserelin / Q000009:adverse effects* / Q000276:immunology; D016022:Case-Control Studies; D003248:Constipation / Q000139:chemically induced; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects* / Q000276:immunology; D005307:Fertilization in Vitro; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007247:Infertility, Female / Q000097:blood* / Q000188:drug therapy*; D043183:Irritable Bowel Syndrome / Q000139:chemically induced*; D007986:Luteinizing Hormone / Q000276:immunology; D008603:Mental Health; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D011446:Prospective Studies; D011974:Receptors, LH / Q000276:immunology; D011966:Receptors, LHRH / Q000276:immunology; D014839:Vomiting / Q000139:chemically induced
chemical_list: D001323:Autoantibodies; D005300:Fertility Agents, Female; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D011974:Receptors, LH; D011966:Receptors, LHRH; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D002064:Buserelin