Fan Jiao, Zhong Yiping, Chen Cuina
Key Laboratory of Reproductive Medicine of Guangdong Province, Reproductive Medicine Center for The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Am J Reprod Immunol. 2016 Nov;76(5):391-395. doi: 10.1111/aji.12559. Epub 2016 Sep 13.
Antinuclear antibody (ANA) could cause reproductive failure. But treatment for women with antinuclear antibody was controversial.
One hundred and thirty-three ANA+ women with one-time in vitro fertilization (IVF) implantation failure were divided into two groups randomly. The study group comprised 60 sero-positive for antinuclear antibody. These patients were treated with prednisone (10 mg/day) and aspirin (100 mg/day) starting 3 months before induction of ovulation in 60 IVF cycles. Seventy-three patients were included in untreated group.
Fertilization rate, pregnancy rate, and implantation rate were significantly higher in treatment group, while abortion rate was markedly higher in non-treatment group by randomized controlled trial. Same conclusions were also proved between cycles of 60 ANA+ women with therapy and their former cycles without any treatment.
Combined treatment of prednisone for immunosuppression and aspirin as an antithrombotic agent, starting 3 months before ovulation induction, may improve reproductive outcomes in ANA+ patients.
抗核抗体（ANA）可能导致生殖失败。但抗核抗体阳性女性的治疗存在争议。
133例经历单次体外受精（IVF）着床失败的ANA阳性女性被随机分为两组。研究组包括60例抗核抗体血清阳性患者。这些患者在60个IVF周期中，于促排卵前3个月开始接受泼尼松（10毫克/天）和阿司匹林（100毫克/天）治疗。73例患者纳入未治疗组。
通过随机对照试验发现，治疗组的受精率、妊娠率和着床率显著更高，而未治疗组的流产率明显更高。60例接受治疗的ANA阳性女性的周期与其之前未接受任何治疗的周期之间也得出了相同结论。
在促排卵前3个月开始，联合使用泼尼松进行免疫抑制治疗和阿司匹林作为抗血栓药物，可能改善ANA阳性患者的生殖结局。
