Controlled Ovarian Hyperstimulation Changes the Prevalence of Serum Autoantibodies in In Vitro Fertilization Patients

Authors

  • Kadri Haller,

    1. Department of Immunology, Institute of General and Molecular Pathology, Centre of Molecular and Clinical Medicine, University of Tartu, Tartu, Estonia;
    2. Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia;
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  • Aili Sarapik,

    1. Department of Immunology, Institute of General and Molecular Pathology, Centre of Molecular and Clinical Medicine, University of Tartu, Tartu, Estonia;
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  • Ija Talja,

    1. Department of Immunology, Institute of General and Molecular Pathology, Centre of Molecular and Clinical Medicine, University of Tartu, Tartu, Estonia;
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  • Andres Salumets,

    1. Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia;
    2. Nova Vita Clinic, Centre for Infertility Treatment and Medical Genetics, Haabneeme, Viimsi County, Harjumaa, Estonia;
    3. Institute of Molecular and Cell Biology, University of Tartu, Estonian Biocentre, Tartu, Estonia
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  • Raivo Uibo

    1. Department of Immunology, Institute of General and Molecular Pathology, Centre of Molecular and Clinical Medicine, University of Tartu, Tartu, Estonia;
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Raivo Uibo, Department of Immunology, Institute of General and Molecular Pathology, Centre of Molecular and Clinical Medicine, University of Tartu, Ravila Str. 19, Biomedicum, Tartu 50411, Estonia.
E-mail: raivo.uibo@ut.ee

Abstract

Problem  Autoimmune mechanisms are involved in etiology of female infertility, the medical problem frequently treated by in vitro fertilization (IVF). Controlled ovarian hyperstimulation (COH) with supraphysiological levels of sex hormones is achieved by IVF.

Methods of study  Anti-human-ovary and eight common autoantibodies [nuclear (ANA-H, ANA-R on human HEp-2 cell line and rodent antigen, respectively), smooth muscle (SMA), parietal cell, thyroid microsomal, mitochondrial, β2-glycoprotein-I, cardiolipin antibodies] found in IVF patients (n = 129) were analyzed with regard to the number of previous IVF procedures and the age of the patient. The changes in autoimmune reactions caused by the COH were determined.

Results  Endometriosis and polycystic ovary syndrome were associated with a higher number of common serum autoantibodies compared with the tubal factor infertility (Proportion test, P < 0.05). ANA-R was associated with unexplained infertility [adjusted odds ratio (aOR) 8.79, P = 0.038]. SMA correlated with endometriosis (aOR 37.29, P = 0.008), male factor infertility (aOR 20.45, P = 0.018) and with the previous IVF procedures (aOR 2.87, P = 0.013). There was an overall decrease in the number of detectible autoantibodies after COH (Proportion test, P < 0.05).

Conclusion  COH may have a suppressive effect on the humoral immunity by the time of embryo transfer but more conclusive studies are needed.

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