Ho H N, Yang Y S, Hsieh R P, Lin H R, Chen S U, Chen H F, Huang S C, Lee T Y, Gill T J
Department of Obstetrics and Gynecology, School of Medicine and Hospital, National Taiwan University, Taipei, Republic of China.
Am J Obstet Gynecol. 1994 Jan;170(1 Pt 1):63-71. doi: 10.1016/s0002-9378(94)70385-x.
The purpose was to test further our hypothesis that genes, or genetic defects, linked to the major histocompatibility complex affect reproduction by correlating human leukocyte antigen sharing with the success or failure of in vitro fertilization and tubal embryo transfer in couples having unexplained infertility.
Seventy-six couples with unexplained infertility who failed superovulation and intrauterine insemination at least three times were typed for human leukocyte antigens and treated by in vitro fertilization and tubal embryo transfer. The results were correlated with the sharing of human leukocyte antigens in the couples.
Thirty-four of the women had successful pregnancies, 36 did not become pregnant, and six became pregnant but aborted shortly thereafter. There was a highly significant excess of human leukocyte antigen sharing in the couples who failed treatment: three of the A, B, DR, and DQ antigens (p = 0.015) or two of the B, DR, and DQ antigens (p = 0.015). No specific human leukocyte antigen alleles were present in excess.
Genes, or genetic defects, linked to the major histocompatibility complex significantly affect the success of in vitro fertilization and tubal embryo transfer just as they affect the prevalence of recurrent spontaneous abortion, cancer, and congenital anomalies. It appears as if the critical genes, or genetic defects, are located in the B-DR-DQ region of the major histocompatibility complex.
进一步验证我们的假说，即与主要组织相容性复合体相关的基因或基因缺陷通过将人类白细胞抗原共享情况与不明原因不孕夫妇体外受精及输卵管内胚胎移植的成败相关联，从而影响生殖。
对76对不明原因不孕且至少三次超排卵及宫内人工授精失败的夫妇进行人类白细胞抗原分型，并接受体外受精及输卵管内胚胎移植治疗。将结果与夫妇间人类白细胞抗原共享情况相关联。
34名女性成功妊娠，36名未妊娠，6名妊娠但随后不久流产。治疗失败的夫妇中人类白细胞抗原共享显著过量：A、B、DR和DQ抗原中的三种（p = 0.015）或B、DR和DQ抗原中的两种（p = 0.015）。不存在特定人类白细胞抗原等位基因过量的情况。
与主要组织相容性复合体相关的基因或基因缺陷显著影响体外受精及输卵管内胚胎移植的成功率，正如它们影响复发性自然流产、癌症及先天性异常的发生率一样。关键基因或基因缺陷似乎位于主要组织相容性复合体的B - DR - DQ区域。
