Antiphospholipid autoantibodies testing in women with unexplained infertility and recurrent first trimester abortion
Keywords:
Antiphospholipid Antibodies, Unexplained Infertility, Recurrent First Trimester Abortion
Abstract
Objective: To assess the occurrence of antiphospholipid auto-antibodies (aPLA) in women suffering from unexplained infertility or recurrent first trimester abortion to evaluate their pathogenic role in these disorders. Setting: King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia.
Patients and Methods: Between June 2013 and December 2014, a prospective study was carried out on 20 women with unexplained fertility (group A), 20 women with recurrent first trimester abortion (group B), compared to 20 healthy women as control (group C). IgA, IgM, and IgG against phospholipids were detected in the sera of all cases.
Results: It was found that IgA, IgM and IgG levels were significantly higher in group A, B when compared to group C. Venereal Diseases Research Laboratory (VDRL) test was positive in 2 (10%) cases in group A and 3 (15%) cases in group B but it was negative in group C. Lupus anticoagulant (LA), tested by the activated partial thromboplastin time (APTT), was prolonged in 4 (20%) group A and 3 (15%) cases in group B.
Conclusion: From the results of this study it can be concluded that reproductive performance may be affected by the abnormal presence of antiphospholipid auto-antibodies.
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References
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25. Gharavi AE, Harris EN, Asherson RA and Hughes GR. Isotype distribution and phospholipid specificity in the antiphospholipid syndrome. Ann Rheum Dis 1987; 46:1-6. doi:10.1136/ard.46.1.1
26. Rote NS, Johnson D and Branch DW. Ant phospholipid antibodies and recurrent pregnancy loss correlation between the PTT and antibodies against phosphatidylserine and cardiolipin. Am J Obstet Gynecol 1990; 163:575-584. doi: 10.1016/0002-9378(90)91201-M
27. Wong, L. F., T. F. Porter, and G. R. de Jesús. "Recurrent early pregnancy loss and antiphospholipid antibodies: where do we stand?." Lupus 23.12 (2014): 1226-1228. doi: 10.1177/0961203314529170. [PubMed]
28. Crowchock S,Smith B and Gocial B.Antibodies to phospholipids and nuclear antigen in patients with repeated abortion.Am J Obstet Gynecol 1998; 155:1002-1010. doi:10.1016/0002-9378(86)90335-2.
29. Cowchock, Susan, J. Bruce Smith, and Benjamin Gocial. "Antibodies to phospholipids and nuclear antigens in patients with repeated abortions. American journal of obstetrics and gynecology 155.5 (1986): 1002-1010. doi:10.1016/0002-9378(86)90335-2.
2. Lockshin MD, Qamar T and Levy RA. Anticardiolipin and related antibosies: thrombosis and fetal death. In: Scott JS, Bird HA, editors. Pegnancy, autoimmunity and connective tissue disorders. Oxford University Press 1990;185-211.
3. Carp, H. J. A., and Y. Shoenfeld. "Anti-phospholipid antibodies and infertility.Clinic rev. Allerg . immunol. (2007) 32: 159-161.doi 10.1007/s12016-007-0010-2. [PubMed]
4. Gupta, Sajal, et al. "The role of oxidative stress in spontaneous abortion and recurrent pregnancy loss: a systematic review. Obstetrical & gynecological survey 62.5 (2007): 335-347.doi: 10.1097/01.ogx.0000261644.89300.df.
5. Younis JS, Ohel G, Bernner B, Haddad S, Lanir N, Ben-Ami M. The effect of thrombophylaxis on pregnancy outcome in patients with recurrent pregnancy loss associated with factor V Leiden mutation. BJOG 2000; 197:153-159. doi: 10.1111/j.1471-0528.2000.tb13240.x
6. Mc Intry J. Antiphospholipid antibodies in implantation failure. Am J Repro Immunology 2003; 107(3):415-9. doi: 10.1034/j.1600-0897.2003.01197.x
7. Birkenfeld A, Mukaida T, Minichiello L, Jackson M, Kase NG, Yemini M. Incidence of autoimmune antibodies in failed embryo transfer cycles. Am J Repeo Immunol 1994;31:65-8. doi: 10.1111/j.1600-0897.1994.tb00848.x
8. Geircger N, Pratt D and Dudkiewicz A. What we really know about autoantibody abnormalities and reproductive failure: A Critical review. Autoimmunity 1973; 16:115-140.
9. Balasch J, Montserrat C and Fabregues F. Antiphospholipid antibodies and human reproductive failure. Hum Reprod 1996; 11:2310-2315. [PubMed]
10. Wilcox AJ, Weiberg CR, O'Connor JF et al. Incidence of early loss of pregnancy. N Engl J Med 1988; 319:18. doi: 10.1056/NEJM198807283190401
11. Proctor RR and Rappaport SI. The partial thromboplastin time with kaolin: a simple screening test for first stage plasma clotting factor deficiencies. Am J Clin Pathol 1961; 36:212-216.
12. Lubbe WF, Butler WS, Palmer SJ and Liggins GC. Lupus anticoagulant in pregnancy. BJOG 1984; 357-63. doi: 10.1111/j.1471-0528.1984.tb05923.x
13. Branch DW, Scott JR, Kochemour Nk and Hershogold E. Obstetric complications associated with lupus anticoagulant. N Engl J Med 1986;313:1322-1326. [PubMed]
14. Billingham RF and Head JR. Current trends in reproductive immunology an overview. J Rep Immunol 1981; 3:253-265. doi: 10.1056/NEJM198511213132104. [PubMed]
15. Roussev RG, Kadaider BD, Price DE, Coulman CB. Laboratory evaluation of women experiencing reproductive failure. Am J Repord Immunol 1996; 35:415-420. doi: 10.1111/j.1600-0897.1996.tb00503.x
16. Gleicher N, El Roely A, Confino E, and Friberg J. Reproductive failure because of auto-immune antibodies: unexplained infertility and pregnancy wastage. Am J Obstet Gynecol 1986;160:1376-1385. doi: http://dx.doi.org/10.1016/0002-9378(89)90858-2.
17. Kutteh WH, Lyda EC, Abraham SM and Wacholtz MC. Association of anticardiolipin antibodies and pregnancy loss in women with systemic lupus erythromatosis. Fertil Steril 1993;60:449-455.
18. Fisch B, RIkover Y and Shobat L. The relationship between in virto fertilization and naturally occurring antibodies: Evidence of increased production of antiphospholipid antibodies. Fertil Steril 1991;56:718-724.
19. Royburt M, Yron I and Fisch B. Autoimmune disorders and reproductive failure. Hum Reprod 1996;11:1138-1139.
20. Battaglia C, Sgarbi L and Salvatori M. Increased anticardiolipin antibodies are positively related to pulsatility index in unexplained infertility. Hum Reprod 1998; 13:3487-3491. doi: 10.1093/humrep/13.12.3487
21. Bouvier S, Cochery-Nouvellon E, Lavigne-Lissalde G, et al. Comparative incidence of pregnancy outcomes in treated obstetric antiphospholipid syndrome: the NOH-APS observational study. Blood J. 2014; 123(3):404-13. doi: http://dx.doi.org/10.1182/blood-2013-08-522623.
22. Harris EN, Gharani AE and Hefge U. Anticardiolipin antibodies in autoimmune thrombocytopenic purpura. Br J Hematol 1985; 59:231-234. doi: 10.1111/j.1365-2141.1985.tb02989.x
23. Cariou R, Tobelem G and Bellucci S. Effect of lupus anticoagulant on antithrombogenic properties of endothelial cells: inhibition of thrombomodulin dependent protein C activation. Thrombo Hemost 1988; 69:54-58.
24. Kowalik A, Vichnin M and Chig L. Midfollicular anticardiolipin and antiphophatidylserine antibody titers do not correlate with in virto fertilization outcome. Fertil Steril 1997;68:298-304. doi:10.1016/S0015-0282(97)81519-1.
25. Gharavi AE, Harris EN, Asherson RA and Hughes GR. Isotype distribution and phospholipid specificity in the antiphospholipid syndrome. Ann Rheum Dis 1987; 46:1-6. doi:10.1136/ard.46.1.1
26. Rote NS, Johnson D and Branch DW. Ant phospholipid antibodies and recurrent pregnancy loss correlation between the PTT and antibodies against phosphatidylserine and cardiolipin. Am J Obstet Gynecol 1990; 163:575-584. doi: 10.1016/0002-9378(90)91201-M
27. Wong, L. F., T. F. Porter, and G. R. de Jesús. "Recurrent early pregnancy loss and antiphospholipid antibodies: where do we stand?." Lupus 23.12 (2014): 1226-1228. doi: 10.1177/0961203314529170. [PubMed]
28. Crowchock S,Smith B and Gocial B.Antibodies to phospholipids and nuclear antigen in patients with repeated abortion.Am J Obstet Gynecol 1998; 155:1002-1010. doi:10.1016/0002-9378(86)90335-2.
29. Cowchock, Susan, J. Bruce Smith, and Benjamin Gocial. "Antibodies to phospholipids and nuclear antigens in patients with repeated abortions. American journal of obstetrics and gynecology 155.5 (1986): 1002-1010. doi:10.1016/0002-9378(86)90335-2.
CITATION
DOI: 10.17511/joog.2015.i01.04
Published: 2015-06-30
How to Cite
Al-Bezrah, N. K. (2015). Antiphospholipid autoantibodies testing in women with unexplained infertility and recurrent first trimester abortion. Obs Gyne Review: Journal of Obstetric and Gynecology, 1(1), 14-20. https://doi.org/10.17511/joog.2015.i01.04
Section
Original Article
Copyright (c) 2015 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
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