Immunodiagnostic evaluation in women with reproductive failure

Citation
As. Kaider et al., Immunodiagnostic evaluation in women with reproductive failure, AM J REPROD, 42(6), 1999, pp. 335-346
Citations number
95
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Immunology
Journal title
AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY
ISSN journal
1046-7408 → ACNP
Volume
42
Issue
6
Year of publication
1999
Pages
335 - 346
Database
ISI
SICI code
1046-7408(199912)42:6<335:IEIWWR>2.0.ZU;2-Q
Abstract
PROBLEM: Several immunological factors have been associated with diagnostic subpopulations of reproductive failure. It is important to determine a tre nd of immunological abnormalities among these subpopulations. The purpose o f this study is to assist in the selection of treatment for patients suspec ted of having specific diagnoses of reproductive failure. METHOD OF STUDY: Blood samples from 591 patients were evaluated for the pre sence of antiphospholipid (APA), antinuclear (ANA), and antithyroid (ATA) a ntibodies, as well as for lupus anticoagulant (LA), embryotoxic factors (ET F), and elevated levels of natural killer (NK) (CD56(+)) cells, and all tes ts were performed as a panel. The patients were grouped into the following diagnostic categories: recurrent pregnancy loss (n = 302), IVF/ET failure ( IVFf, n = 122), unexplained infertility (n = 97), ovarian dysfunction (n = 47), and endometriosis (il = 23). The thresholds for positivity and the pre valence of the tested factors among normal healthy populations have been es tablished by resting 100 ol more healthy male and female individuals with e ach one of the tests used (general population control). All tests as panel were performed on 20 normal fertile female individuals as controls (fertile female controls). RESULTS: Of all patients with reproductive failure, 75.6% had at least one abnormal test. The most frequent abnormal result was found to be the elevat ion of NK (CD56(+)) cells (37%), followed by ANA (34%), APA (24%), ATA (19% ), and ETF (11%). Of the recurrent pregnancy loss patients, 74.2% had at le ast one positive abnormal result from all of the tests performed, overall, 70% of women with IVF failure had at least one abnormal test; of patients d iagnosed with unexplained infertility, approximately 81% had at least one a bnormal result; 74.4% of the patients with ovarian dysfunction and 52% of t he patients with endometriosis had at least one abnormal result. From norma l fertile controls, 10% showed at least one abnormal test result. CONCLUSION: APA. ANA, ATA, ETF, and elevated NK (CD56(+)) cells are signifi cantly more prevalent among women experiencing reproductive failure than am ong the control group and normal healthy individuals.