Human reproductive failure is not a clinical feature associated with beta(2) glycoprotein-I antibodies in anticardiolipin and lupus anticoagulant seronegative patients (the antiphospholipid/cofactor syndrome)

It has been suggested that patients with clinical features suggestive of an tiphospholipid syndrome but being lupus anticoagulant (LA) and anticardioli pin (aCL) negative, should be tested for antibodies to beta(2) glycoprotein -I (a beta(2)GP-I), a protein involved in the binding of antiphospholipid a ntibodies (aPL) to phospholipid surfaces, This was investigated in the pres ent study where a total of 385 women aged less than or equal to 40 years we re included. Of these, 175 were experimental subjects and 210 were controls , The former comprised the following two study groups: 100 spontaneous recu rrent aborters (group one), and 75 patients with repeated failure of embryo transfer (group two), Controls included three groups of women: 100 normal healthy parous women with no previous abortion (group three), 60 infertile patients achieving a live birth with their first in-vitro fertilization (IV F)/embryo transfer attempt (group four), and 50 patients with recurrent abo rtion who tested positive for aPL (LA and/or aCL) (positive controls, group five). Only one patient among recurrent aborters (group one) tested positi ve for a beta(2)GP-I, All women in groups two, three and four were negative for a beta(2)GP-I screening. As expected, prevalence of patients testing p ositive for a beta(2)GP-I was significantly higher in group five than among the other groups of patients (P < 0.001). No differences were observed reg arding the prevalence of a beta(2)GP-I positive sera in the subgroup of pat ients having aCL and those having the LA in group five. It is concluded tha t a beta(2)GP-I screening in first-trimester recurrent abortion or in failu re of implantation after IVF is not warranted in patients without aPL as de tected by standard antiphospholipid assays.