Clinical significance of naturally occurring anti-zona pellucida antibodies in infertile women.

Although implicated in the etiology of unexplained infertility, a primary role for antibodies to zona pellucida antigens remains uncertain. We therefore prospectively studied 21 infertility patients found to have significant anti-zona pellucida antibody titers (1:4 to 1:16). When treated for endometriosis or other concurrent fertility problems, 7 of the 21 (33%) delivered viable infants. Two other patients conceived without treatment. Decreases in anti-zona antibody titers were found in most but not all women with successful outcomes. In a given individual, anti-zona antibodies may coexist with other fertility disorders. Therefore, these antibodies should not preclude treatment of concurrent fertility disorders.