AUTOANTIBODIES AND ANTISPERM ANTIBODIES IN SERA AND FOLLICULAR FLUIDSOF INFERTILE PATIENTS - RELATION TO REPRODUCTIVE OUTCOME AFTER IN-VITRO FERTILIZATION

Immune reactions have effects at various concentrations in the reprodu ctive process and autoantibodies may have an impact on fertility and t he outcome of assisted conception. We measured the prevalence of and r elation between antibodies to smooth muscle, nuclear, phospholipid and sperm antigens, and concentrations of immunoglobulins G, M and A and complement components C3 and C4, in the sera and follicular fluids of women with unexplained infertility (n = 30), endometriosis (n = 20), t ubal infertility (n = 50) and the sera of 20 normal non-pregnant women . We assessed fertilization and successful pregnancy rates in relation to antibody status of infertile women after in vitro fertilization. A ll antibodies had a higher prevalence in infertile women compared with controls and this was significant for smooth muscle antibody in endom etriosis (P < 0.05); anticardiolipin antibody in tubal infertility (P < 0.05); and antisperm antibody in all types of infertility (P < 0.001 ). There was no relation between presence of specific antibodies in se rum or between serum and follicular fluids. Total biochemical pregnanc y rate was higher with endometriosis (P = 0.05) but clinical pregnancy and live birth rates did not differ between groups or in relation to antibody status. Significant differences in immunoglobulin and complem ent components occurred in women with and without successful biochemic al pregnancy.