AUTOANTIBODIES AND INFERTILITY - A REVIEW OF THE LITERATURE

The role that autoantibodies play in infertility remains uncertain. Th ere are conflicting data regarding the prevalence of autoantibodies in women with endometriosis. Certainly no one has demonstrated an associ ation between the presence of antibodies in women with endometriosis a nd infertility. Despite intensive study, there is also no consensus on a role of autoantibodies to the zona pellucida as a cause of infertil ity. Recently, much attention has been focused on autoantibodies and i nfertility particularly with regards to phospholipid antibodies and th eir effect on IVF success rates. The literature suggests that women wi th infertility have an increased prevalence of phospholipid antibodies compared to fertile women. However, the presence of these antibodies has not been associated with a worsened prognosis for IVF cycles. Many questions remain to be answered. What is the cause of this apparently increased prevalence of autoantibodies in infertile women? Do these a utoantibodies cause infertility or are they merely associated with som e other condition which is actually causitive? Finally, can treatment of autoantibodies improve pregnancy rates in infertile couples after I VF or other infertility treatments? The answers to these questions sho uld be sought by carefully conducted trials with appropriate control g roups. Subjecting patients to expensive testing and 'treatments' befor e these answers are known is not consistent with good scientific or me dical practice. (C) 1997 Elsevier Science Ireland Ltd.