Abstract
Several autoimmune factors have been investigated as possible influences on reproductive success of both natural conception and conception by the use of assisted reproductive technologies. In order for a pregnancy to succeed, two immunologically and genetically distinct tissues must coexist. During implantation, local and systemic immune factors, cytokines, and growth factors may interact with adhesion molecules and other matrix-associated proteins, glycoproteins, and peptides. Antiphospholipid antibodies are identified more frequently in women undergoing in vitro fertilization, but their presence does not appear to influence the outcome of pregnancy, miscarriage, or live birth rates. Antithyroid antibodies are commonly found in women of reproductive age, but implantation rates and miscarriage rates are not altered when women have normal thyroid function. Antinuclear antibodies may be a marker for underlying autoimmune disease when coupled with certain signs and symptoms, but low titer antibodies do not influence in vitro fertilization outcome. Antisperm antibodies are more often associated with fertilization failure when found in high titers in seminal plasma, on sperm, or in the mucosal immune system of women. Antiovarian antibodies are uncommon, but most often associated with ovarian hypofunction. Other autoimmune factors are under investigation as markers of in vitro fertilization failure.
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Funding: Frank Ling Research Grant in Obstetrics and Gynecology.
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Odom, L.N., Cline, A.M., Kutteh, W.H. (2011). Autoimmunity and Female Infertility: Fact vs. Fiction. In: Racowsky, C., Schlegel, P., Fauser, B., Carrell, D. (eds) Biennial Review of Infertility. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-8456-2_1
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