Gonadotropins do not induce antiphospholipid antibodies

PROBLEM: To determine whether the increased incidence of antiphospholipid a ntibodies (APAs) in women undergoing assisted reproduction might be seconda ry to superovulation with gonadotropins, predisposing women to an abnormal immune response and thus inducing APAs. METHOD OF STUDY: Women undergoing assisted reproduction with gonadotropins for the first time were selected and tested before the initiation of the st imulation cycle, during the cycle, and at the end of the cycle (group 1). W omen who had undergone gonadotropin stimulation at least 60 days earlier (g roup 2) and normal, nonpregnant, fertile women (group 3) also were evaluate d. Serum samples were assayed by the enzyme-linked immunosorbent assay meth od. RESULTS: Ten (20%) of 50 women in group 1 were positive for APAs. The 10 wo men who were positive for APAs remained positive throughout the treatment c ycle. Positive antibodies were identified in 12 (24%) of 50 women in group 2, not significantly different from group 1 (P = 0.81). Antibodies were pre sent in 2 of 50 normal fertile control subjects, significantly less frequen tly than in group 1 (P < 0.03) and in group 2 (P < 0.01). CONCLUSIONS: These data suggest that gonadotropin administration and/or the ovarian response to stimulation does not predispose women to the induction of APAs. Moreover, the incidence of APAs in this population, which is high er than that found in normal fertile women, cannot be explained by cycle-in duced events.