Matsubayashi Hidehiko, Sugi Toshitaka, Arai Tadashi, Shida Masako, Kondo Akane, Suzuki Takahiro, Izumi Shun-ichiro, McIntyre John A
Department of Obstetrics and Gynecology, Specialized Clinical Science, Tokai University School of Medicine, Kanagawa, Japan.
Am J Reprod Immunol. 2006 May;55(5):341-8. doi: 10.1111/j.1600-0897.2006.00374.x.
Patients undergoing in vitro fertilization and embryo transfer (IVF-ET) failures show an increased incidence of antiphospholipid antibodies (aPL) in their blood. The physiological manifestations of aPL in this patient group are nonetheless controversial. Pathological effects of aPL on embryos in vitro have been documented. We questioned whether aPL if found in follicular fluids (FFs) could result in embryonic damage.
Blood from 44 patients with three or more IVF-ET failures were tested by enzyme-linked immunosorbent assays (ELISA) for the presence of immunoglobulin (Ig)G, IgM and IgA aPL. Both the 29 aPL-positive and 15 aPL-negative patients gave permission for FF collection during their next IVF-ET attempt for additional aPL determinations.
Patients with no aPL in their blood, had no aPL in their FFs. Patients with IgG and/or IgM aPL in their blood had IgG but not IgM in their respective FFs.
The presence of IgG aPL in FFs and increased infertility length were significantly related to lower fertilization rates, independently. Follicular fluid IgG aPL appears as a risk factor in association with successful IVF-ET outcomes.
接受体外受精和胚胎移植（IVF-ET）失败的患者血液中抗磷脂抗体（aPL）的发生率增加。然而，该患者群体中aPL的生理表现仍存在争议。aPL对体外胚胎的病理作用已有文献记载。我们质疑在卵泡液（FFs）中发现的aPL是否会导致胚胎损伤。
对44例经历三次或更多次IVF-ET失败的患者的血液进行酶联免疫吸附测定（ELISA），以检测免疫球蛋白（Ig）G、IgM和IgA aPL的存在。29例aPL阳性患者和15例aPL阴性患者均同意在下次IVF-ET尝试期间收集FFs，以进行额外的aPL测定。
血液中无aPL的患者，其FFs中也无aPL。血液中存在IgG和/或IgM aPL的患者，其各自的FFs中存在IgG但不存在IgM。
FFs中IgG aPL的存在和不孕时间延长与较低的受精率显著独立相关。卵泡液IgG aPL似乎是与IVF-ET成功结果相关的一个危险因素。
