Universitat Autònoma de Barcelona, Barcelona, Spain.
Systemic Autoimmune Research Unit, Vall d'Hebron Institut de Recerca, Barcelona, Spain.
Autoimmun Rev. 2022 Jun;21(6):103101. doi: 10.1016/j.autrev.2022.103101. Epub 2022 Apr 20.
Antiphospholipid antibodies (aPL) are related to poor pregnancy outcomes, but their effect on embryo implantation is unclear. We aimed to assess the prevalence of different aPL in women with recurrent implantation failure (RIF).
We searched studies in PubMed (MEDLINE), Scopus and Cochrane Library. Quality of studies was scored by the Newcastle-Ottawa Scale and risk of bias assessment by items described in RevMan5 software. Statistical analyses were made using random-effects model and presented as pooled Odds Ratio (OR), 95% confidence interval (CI). Heterogeneity was assessed by I% and D%.
This systematic review and meta-analysis included 17 studies and showed a high degree of variability in aPL positivity in RIF. In the latter, the risk of bias assessment suggested unclear bias on study performance with a median sample size and interquartile range for RIF patients and fertile women of 96 (57-417) and 100 (60.5-202.5), respectively. Among the criteria aPL, IgG anticardiolipin autoantibodies (OR 5.02, 95% CI [1.95, 12.93]) were associated with RIF. Within the non-criteria aPL, anti-β2 glycoprotein I-IgA (OR 64.8, 95% CI [9.74, 431.0]), and antiphosphatidylglycerol-IgG and IgM (OR 10.74, 95% CI [5.25, 22.0]; OR 4.26, 95% CI [1.76,10.31]; respectively) were associated with RIF, too.
Anticardiolipin-IgG is a prevalent autoantibody in women with RIF. Three other non-criteria aPL, aβ2GP I-IgA, aPG-IgG and aPG-IgM also present a positive rate in RIF. Overall, these results advise about testing them as indicators of RIF risk in women seeking IVF treatment.
抗磷脂抗体（aPL）与不良妊娠结局有关，但它们对胚胎着床的影响尚不清楚。我们旨在评估复发性着床失败（RIF）妇女中不同 aPL 的患病率。
我们在 PubMed（MEDLINE）、Scopus 和 Cochrane 图书馆中搜索研究。使用 Newcastle-Ottawa 量表对研究质量进行评分，并使用 RevMan5 软件中描述的项目对偏倚风险进行评估。使用随机效应模型进行统计分析，并以汇总优势比（OR）、95%置信区间（CI）表示。通过 I%和 D%评估异质性。
本系统评价和荟萃分析纳入了 17 项研究，显示 RIF 中 aPL 阳性率存在高度变异性。在后者中，偏倚评估表明研究表现存在不明确的偏倚，RIF 患者和生育女性的中位样本量和四分位距分别为 96（57-417）和 100（60.5-202.5）。在 aPL 标准中，IgG 抗心磷脂自身抗体（OR 5.02，95%CI [1.95，12.93]）与 RIF 相关。在非标准 aPL 中，抗β2 糖蛋白 I-IgA（OR 64.8，95%CI [9.74，431.0]）和抗磷脂酰甘油-IgG 和 IgM（OR 10.74，95%CI [5.25，22.0]；OR 4.26，95%CI [1.76，10.31]）也与 RIF 相关。
抗心磷脂 IgG 是 RIF 妇女中常见的自身抗体。另外三种非标准 aPL，即β2GP I-IgA、aPG-IgG 和 aPG-IgM，在 RIF 中也有一定的阳性率。总的来说，这些结果表明，在接受 IVF 治疗的女性中，检测这些抗体可以作为 RIF 风险的指标。
