Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, United States.
Front Immunol. 2022 Nov 2;13:986893. doi: 10.3389/fimmu.2022.986893. eCollection 2022.
The purpose of the study is to evaluate the effects of anticardiolipin (aCL) and/or anti-β2-glycoprotein-I (aβ2GPI) antibodies, namely antiphospholipid antibodies (aPL), on fertilization (IVF) outcomes.
The study group comprised infertile women with aPL undergoing IVF-ET cycles. Controls were infertile women with tubal etiology without aPL. The impact of aPL on reproductive outcomes, such as oocyte quality, embryo quality, and implantation capacity, was compared between the study group and controls. Additionally, peripheral blood T cell subsets, such as T helper (Th)1, Th2, Th17, and T regulatory (Treg) cells and cytokines, were analyzed by the flow cytometry. Differences between the study group and controls were analyzed.
A total of 132 infertile women, including 44 women with aPL, and 88 controls were sequentially recruited for this study. Women with aPL had lower numbers of total and perfect/available embryos and lower rates of MII oocytes, blastocyst formation, perfect and available embryos, implantation, clinical pregnancy, and take-home baby. Additionally, imbalanced Th1/Th2 and Th17/Treg ratios, significantly higher levels of serum IL-2, TNF-α, IFN-γ, and IL-17A, and a significantly lower serum IL-4 were noticed in women with aPL compared to controls.
Women with aPL such as aCL and/or aβ2GPI antibodies were associated with adverse IVF outcomes. Early screening for aPL and appropriate consultation for couples undergoing IVF should be considered. In addition, underlying immunopathology and inflammatory immune mechanisms associated with aPL should be further explored.
本研究旨在评估抗心磷脂（aCL）和/或抗β2-糖蛋白 I（aβ2GPI）抗体（即抗磷脂抗体[aPL]）对体外受精（IVF）结局的影响。
研究组包括接受 IVF-ET 周期治疗的伴有 aPL 的不孕女性。对照组为无 aPL 的输卵管病因不孕女性。比较研究组与对照组 aPL 对卵母细胞质量、胚胎质量和着床能力等生殖结局的影响。此外，通过流式细胞术分析外周血 T 细胞亚群，如辅助性 T 细胞（Th）1、Th2、Th17 和调节性 T（Treg）细胞和细胞因子。分析研究组与对照组之间的差异。
本研究共纳入 132 例不孕女性，其中 44 例伴有 aPL，88 例为对照组。伴有 aPL 的女性总胚胎和优质/可用胚胎数量较少，MII 卵母细胞、囊胚形成、优质和可用胚胎、着床、临床妊娠和活产率较低。此外，与对照组相比，伴有 aPL 的女性 Th1/Th2 和 Th17/Treg 比值失衡，血清白介素-2（IL-2）、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）和白介素-17A（IL-17A）水平显著升高，血清白介素-4（IL-4）水平显著降低。
伴有 aCL 和/或 aβ2GPI 抗体等 aPL 的女性与 IVF 结局不良相关。应考虑对接受 IVF 的夫妇进行早期 aPL 筛查和适当咨询。此外，应进一步探讨与 aPL 相关的潜在免疫病理学和炎症免疫机制。
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