title: Female Infertility and Serum Auto-antibodies: a Systematic Review.
abstract: On average, 10 % of infertile couples have unexplained infertility. Auto-immune disease (systemic lupus erythematosus, anti-phospholipid syndrome) accounts for a part of these cases. In the last 20 years, aspecific auto-immunity, defined as positivity of auto-antibodies in blood sample without clinical or biological criteria for defined diseases, has been evoked in a subpopulation of infertile women. A systematic review was performed (PUBMED) using the MESH search terms "infertility" and "auto-immunity" or "reproductive technique" or "assisted reproduction" or "in vitro fertilization" and "auto-immunity." We retained clinical and physiopathological studies that were applicable to the clinician in assuming joint management of both infertility associated with serum auto-antibodies in women. Thyroid auto-immunity which affects thyroid function could be a cause of infertility; even in euthyroidia, the presence of anti-thyroperoxydase antibodies and/or thyroglobulin are related to infertility. The presence of anti-phospholipid (APL) and/or anti-nuclear (ANA) antibodies seems to be more frequent in the population of infertile women; serum auto-antibodies are associated with early ovarian failure, itself responsible for fertility disorders. However, there exist few publications on this topic. The methods of dosage, as well as the clinical criteria of unexplained infertility deserve to be standardized to allow a precise response to the question of the role of serum auto-antibodies in these women. The direct pathogenesis of this auto-immunity is unknown, but therapeutic immunomodulators, prescribed on a case-by-case basis, could favor pregnancy even in cases of unexplained primary or secondary infertility.
authors.affiliation: Internal Medicine Department, Grenoble University Hospital, 38000, Grenoble, France. aderoux@chu-grenoble.fr.|University Grenoble Alpes, 38000, Grenoble, France. aderoux@chu-grenoble.fr.
authors.forename: Alban
authors.identifier: http://orcid.org/0000-0002-9098-7368
authors.initials: A
authors.lastname: Deroux
authors.affiliation: Immunology Department, Laboratory Analysis and Pathology Institute, Grenoble University Hospital, 38000, Grenoble, France.|University Grenoble Alpes, 38000, Grenoble, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Dumestre-Perard
authors.affiliation: Gynecology and Obstetrics Department, Grenoble University Hospital, 38000, Grenoble, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Dunand-Faure
authors.affiliation: Internal Medicine Department, Grenoble University Hospital, 38000, Grenoble, France.|University Grenoble Alpes, 38000, Grenoble, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bouillet
authors.affiliation: Gynecology and Obstetrics Department, Grenoble University Hospital, 38000, Grenoble, France.|University Grenoble Alpes, 38000, Grenoble, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Hoffmann
mesh_terms: D000311:Adrenal Glands / Q000276:immunology; D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology; D017152:Antibodies, Antiphospholipid / Q000097:blood / Q000276:immunology; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology*; D015551:Autoimmunity; D004717:Endometrium / Q000276:immunology; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000276:immunology*; D010053:Ovary / Q000276:immunology; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D014327:Trophoblasts / Q000276:immunology
chemical_list: D000974:Antibodies, Antinuclear; D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies
keywords: Anti-nuclear antibodies; Anti-phospholipid antibodies; Assisted reproduction; Auto-immunity; Immunomodulator; Infertility; Reproductive technique; Serum auto-antibodies