ANTIBODIES TO BETA(2) GLYCOPROTEIN-I ARE ASSOCIATED WITH IN-VITRO FERTILIZATION IMPLANTATION FAILURE AS WELL AS RECURRENT MISCARRIAGE - RESULTS OF A PREVALENCE STUDY

Objective: To investigate whether antiphospholipid and related autoant ibodies are associated with IVF implantation failure as well as with r ecurrent spontaneous miscarriage. Design: Prevalence study. Setting: U niversity teaching hospital and associated IVF unit. Patient(s): Patie nts with at least three consecutive first-trimester miscarriages (n = 97), patients, undergoing IVF who had at least 10 embryos transferred without any resulting clinical pregnancy (n = 105), fertile women (n = 106), and patients newly referred for IVF treatment (n = 52). Interve ntion(s): Antibodies tested included lupus anticoagulant; immunoglobul in (Ig) G and IgM isotypes of each of anticardiolipin antibody, antiph osphatidylserine, antiphosphatidylethanolamine, and antiphosphatidylin ositol; beta(2) glycoprotein I antibodies; and antinuclear antibodies. Statistical analysis included chi(2) and Fisher's exact tests for dif ferences between groups, and multiple linear regression analysis and S pearman's nonparametric tests for relations between results. Main Outc ome Measure(s): Seropositivity for autoantibodies tested. Result(s): O verall, 84 (23%) of the 360 samples tested positive for at least one a utoantibody. beta(2) Glycoprotein I IgM antibody and antinuclear antib ody were significantly associated with both IVF implantation failure a nd recurrent miscarriage. Conclusion(s): Autoantibodies, particularly beta(2) glycoprotein I antibodies and antinuclear antibodies, are asso ciated with IVF implantation failure as well as with recurrent spontan eous abortion, although the mechanism is still unclear. The high serop revalence of antibodies to beta(2) glycoprotein I suggests that it may have an important role in autoimmune reproductive failure that needs to be explored further. (Fertil Steril(R) 1998;70:938-44. (C) 1998 by American Society for Reproductive Medicine.).