The correlation between ANAs and pregnancy loss and their impact on IVF/ICSI-ET pregnancy outcomes in patients with recurrent pregnancy loss.

OBJECTIVE

To explore the correlation between antinuclear antibodies (ANAs) and pregnancy loss (PL), and to observe its impact on the pregnancy outcomes of in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) in recurrent PL (RPL) patients.

METHODS

In this retrospective study, patients first seen at the hospital between January 2016 and December 2022 and who underwent two ANA tests within 4-6 weeks were included. After exclusion of confounding factors, patients were allocated to the non-pregnancy loss (non-PL), single-PL, or RPL group according to previous number of PLs, and the correlation between PL and ANAs was analyzed. The first embryo transfer (ET) after in vitro IVF/ICSI without immunological treatment was placed in the RPL group, and patients were classified into the ANA-negative or ANA-positive subgroup according to ANA titer. The effect of ANAs on pregnancy outcomes in the RPL patients after IVF/ICSI-ET was further analyze.

RESULTS

The results of multivariate unordered logistic regression showed that when the non-PL group was used as the reference, ANA positivity was an independent risk factor for RPL (P = 0.023) but not for single PL (P = 0.654). When the single-PL group was used as the reference, ANA positivity was an independent risk factor for RPL (P = 0.022). Multivariate logistic regression analysis revealed that the early PL rate of the ANA-positive subgroup was significantly higher than that of the ANA-negative subgroup (P = 0.009), and the total PL rate of the ANA-positive subgroup was significantly higher than that of the ANA-negative subgroup (P = 0.049).

CONCLUSION

The results showed that ANA positivity may be related to RPL occurrence, but there was no significant correlation between ANA positivity and single PL. ANA positivity is associated with PL occurrence in RPL patients after transfer, and the correlation is reflected mainly in the first trimester.