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接受体外受精的女性,其妊娠结局不受抗磷脂抗体状态的影响。

Pregnancy outcome is not affected by antiphospholipid antibody status in women referred for in vitro fertilization.

作者信息

Chilcott I T, Margara R, Cohen H, Rai R, Skull J, Pickering W, Regan L

机构信息

Imperial College School of Medicine, London, United Kingdom.

出版信息

Fertil Steril. 2000 Mar;73(3):526-30. doi: 10.1016/s0015-0282(99)00585-3.

Abstract

OBJECTIVE

To determine the prevalence of antiphospholipid (aPL) and anti-beta 2 glycoprotein I (anti-beta2-GPI) antibodies in women referred for IVF and to prospectively evaluate the effect of these antibodies on IVF outcome.

DESIGN

Prospective observational study.

SETTING

A university hospital and IVF unit.

PATIENT(S): Three hundred eighty consecutive women referred for IVF.

INTERVENTION(S): Blood samples taken before commencement of IVF cycles were tested for the presence of aPL (lupus anticoagulant [LA], anticardiolipin [aCL], and antiphosphatidyl serine antibodies [aPS]) and anti-beta2-GPI antibodies.

MAIN OUTCOME MEASURE(S): Antibody prevalence, pregnancy rates, and live birth rates.

RESULT(S): Of the total 380 women, 89 tested persistently positive for aPL (23.4%). None of 176 women tested for IgG aPS antibodies had a positive titer. Only 3.3% (11 of 329) tested positive for anti-beta2-GPI antibodies. Pregnancy rate, live birth rate, gestational age at delivery, and birth weight were not affected by aPL status.

CONCLUSION(S): Although women referred for IVF have a high prevalence of aPL, these antibodies do not affect the outcome of treatment. Screening women undergoing IVF for aPL is not justified.

摘要

目的

确定接受体外受精(IVF)的女性中抗磷脂(aPL)和抗β2糖蛋白I(抗β2-GPI)抗体的患病率,并前瞻性评估这些抗体对IVF结局的影响。

设计

前瞻性观察性研究。

地点

一家大学医院及IVF科室。

患者

380例连续接受IVF的女性。

干预措施

在IVF周期开始前采集血样,检测aPL(狼疮抗凝物[LA]、抗心磷脂[aCL]和抗磷脂酰丝氨酸抗体[aPS])和抗β2-GPI抗体的存在情况。

主要观察指标

抗体患病率、妊娠率和活产率。

结果

在380名女性中,89名aPL检测持续呈阳性(23.4%)。176名接受IgG aPS抗体检测的女性中,无一例滴度呈阳性。仅3.3%(329名中的11名)抗β2-GPI抗体检测呈阳性。妊娠率、活产率、分娩时的孕周和出生体重不受aPL状态的影响。

结论

尽管接受IVF的女性中aPL患病率较高,但这些抗体并不影响治疗结局。对接受IVF的女性进行aPL筛查并无必要。

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