The possible role of antiovary antibodies in repeated in vitro fertilization failures

PROBLEM: The study was conducted to investigate the possible role of circul ating ovarian autoantibodies (ov-ab) in patients with repeated in vitro fer tilization-embryo transfer (IVF-ET) failure and to evaluate the effectivene ss of immunosuppression treatment in these patients. METHOD OF STUDY: The study group comprised 80 IVF patients who had five or more failed treatment cycles (mean 10.2; range 7-22). The presence of ov-ab was compared between these women and 1) 50 IVF patients who conceived duri ng the first three treatment cycles; 2) 50 healthy nulligravidae. All parti cipants were seronegative to nonorgan-specific and antithyroid autoantibodi es. Patients in the study group who were positive for ov-ab were treated wi th 10 mg/day prednisone starting 1 month before ovulation induction. Embryo grading was compared in the IVF cycles before and after treatment. RESULTS: Ov-ab were found in ten patients (12.5%) in the study group, compa red to none in the control groups (P = 0.01). Nine of the patients positive for ov-ab were treated with prednisone for their following cycle. A statis tically significant improvement in embryo grading was noted. Three patients conceived after treatment (33%), with a take-home baby rate of 22%, compar ed to only six patients (8.6%) who conceived among the rest of the seronega tive study group, with a take-home baby rate of 7.1% (P = 0.05). CONCLUSIONS: Ov-ab are a possible marker of an autoimmune disorder that may be one of the causes of repeated IVF failures. Immunosuppression treatment may prove efficient in ov-ab seropositive patients with repeated IVF failu res by improving embryo grading and pregnancy rate.