Kikuchi Kumiko, Shibahara Hiroaki, Hirano Yuki, Kohno Takahiro, Hirashima Chikako, Suzuki Tatsuya, Takamizawa Satoru, Suzuki Mitsuaki
Department of Obstetrics and Gynecology, Jichi Medical School, Kawachi-gun, Tochigi, Japan.
Am J Reprod Immunol. 2003 Oct;50(4):363-7. doi: 10.1034/j.1600-0897.2003.00088.x.
It has been shown that the presence of antinuclear antibody (ANA) might reduce pregnancy rates after in vitro fertilization-embryo transfer (IVF-ET). However, the mechanism of implantation failure by ANA has not yet been clarified. This study was performed to investigate the impact of ANA on pregnancy rates after IVF-ET, and the necessity of specific medication for infertile women who have ANA in their sera.
A total of 108 infertile women were treated by IVF-ET or intracytoplasmic sperm injection (ICSI)-ET. ANA was examined by an indirect fluorescent antibody procedure. Data from women under 40 years old were analyzed retrospectively.
The implantation rates per embryo transferred in the first treatment cycles were 14.8% (eight of 54) and 32.4% (33 of 102), in women with and without ANA, respectively. There was a significant difference in the implantation rates between the two groups (P < 0.05). The pregnancy rates per ET in the first treatment cycles were 28% (seven of 25) and 54.2% (26 of 48), respectively. There was also a significant difference in the pregnancy rates between the two groups (P < 0.05). Afterwards, treatments with IVF-ET or ICSI-ET were repeatedly performed for unsuccessful patients, without any specific medication for ANA. The average ET cycles were 1.80 +/- 1.13 and 1.27 +/- 0.54, in women with and without ANA, respectively. The cumulative pregnancy rates per patient were 68% (17 of 25) and 55.6% (35 of 63), respectively. There was no significant difference in the overall pregnancy rates between the two groups.
These findings suggest that ANA might have an impact on implantation failure in women treated by IVF-ET or ICSI-ET. ANA reduced the pregnancy rates in the first IVF-ET or ICSI-ET cycles but not the cumulative pregnancy rates without medication. This indicates that the mechanisms of implantation failure by ANA could be solved, and effective and safe medication should be developed for better implantation rates, especially in the first treatment cycle.
研究表明，抗核抗体（ANA）的存在可能会降低体外受精-胚胎移植（IVF-ET）后的妊娠率。然而，ANA导致植入失败的机制尚未阐明。本研究旨在探讨ANA对IVF-ET后妊娠率的影响，以及对于血清中存在ANA的不孕女性使用特定药物的必要性。
共有108名不孕女性接受了IVF-ET或卵胞浆内单精子注射（ICSI）-ET治疗。采用间接荧光抗体法检测ANA。对40岁以下女性的数据进行回顾性分析。
在首次治疗周期中，ANA阳性组和ANA阴性组每移植胚胎的植入率分别为14.8%（54个胚胎中有8个植入）和32.4%（102个胚胎中有33个植入）。两组植入率存在显著差异（P<0.05）。首次治疗周期中，ANA阳性组和ANA阴性组每次ET的妊娠率分别为28%（25例中有7例妊娠）和54.2%（48例中有26例妊娠）。两组妊娠率也存在显著差异（P<0.05）。之后，对未成功的患者反复进行IVF-ET或ICSI-ET治疗，但未对ANA采取任何特定药物治疗。ANA阳性组和ANA阴性组患者的平均ET周期分别为1.80±1.13次和1.27±0.54次。每位患者的累积妊娠率分别为68%（25例中有17例妊娠）和55.6%（63例中有35例妊娠）。两组的总体妊娠率无显著差异。
这些发现表明，ANA可能对接受IVF-ET或ICSI-ET治疗的女性的植入失败有影响。ANA降低了首次IVF-ET或ICSI-ET周期的妊娠率，但未降低未用药情况下的累积妊娠率。这表明ANA导致植入失败的机制是可以解决的，应该研发有效且安全的药物以提高植入率，尤其是在首次治疗周期。
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