PROBLEM: The study was conducted to investigate the possible role of circul
ating ovarian autoantibodies (ov-ab) in patients with repeated in vitro fer
tilization-embryo transfer (IVF-ET) failure and to evaluate the effectivene
ss of immunosuppression treatment in these patients.
METHOD OF STUDY: The study group comprised 80 IVF patients who had five or
more failed treatment cycles (mean 10.2; range 7-22). The presence of ov-ab
was compared between these women and 1) 50 IVF patients who conceived duri
ng the first three treatment cycles; 2) 50 healthy nulligravidae. All parti
cipants were seronegative to nonorgan-specific and antithyroid autoantibodi
es. Patients in the study group who were positive for ov-ab were treated wi
th 10 mg/day prednisone starting 1 month before ovulation induction. Embryo
grading was compared in the IVF cycles before and after treatment.
RESULTS: Ov-ab were found in ten patients (12.5%) in the study group, compa
red to none in the control groups (P = 0.01). Nine of the patients positive
for ov-ab were treated with prednisone for their following cycle. A statis
tically significant improvement in embryo grading was noted. Three patients
conceived after treatment (33%), with a take-home baby rate of 22%, compar
ed to only six patients (8.6%) who conceived among the rest of the seronega
tive study group, with a take-home baby rate of 7.1% (P = 0.05).
CONCLUSIONS: Ov-ab are a possible marker of an autoimmune disorder that may
be one of the causes of repeated IVF failures. Immunosuppression treatment
may prove efficient in ov-ab seropositive patients with repeated IVF failu
res by improving embryo grading and pregnancy rate.