The prevalence of antiphospholipid antibodies and effects on the outcomes of in vitro fertilization

Nagham Halki, Naram Khalayli, Ghina Haidar, Waeel Al Halaki, Maysoun Kudsi, Rouaida Abou Samra, Marwan Alhalabi
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Abstract

The problem of infertility is common worldwide. IVF remains the most widely used technique of assisted reproductive technology. Embryo implantation failure is a common cause of unexplained infertility and recurrent miscarriages, thus the relationship between antiphospholipid antibodies and embryo implantation failure after IVF and embryo transfer is an important problem in fertility medicine that must be studied. A retrospective and prospective (bidirectional) cohort study were conducted at the Laboratory Department of the Faculty of Medicine, and Hospital from June 2017 to June 2021. The sample size was 1000 participants, 900 of them were retrospective (2017–2020), and 100 were prospective (2020–2021). Data was collected, including patients’ demographics, type and duration of fertility, and antiphospholipid antibody values. Inclusion criteria-Women <40 years old, undergoing IVF, and in the retrospective study, patients who undergo IVF and who have antibody data, positivity of phospholipids, and/or anticardiolipin, and/or B2 glycoprotein I, and the presence of the gestational sac on ultrasound as a criterion for pregnancy. We performed a PTT LA for the control group in a cohort study (20 healthy women), then a PTT LA test, and the blending test were performed, and the values were considered positive if the correction was not made. The PTT LA test is a screening test. The average age of the women was 31.91, the success rate of assisted fertilization in inducing pregnancy in the last trial was 52.8%, the prevalence was 4.4% of anticardiolipin IgG, 2.6% of anticardiolipin IgM, and 4% of Lupus anticoagulant. No relation was found between the antiphospholipid value and the age of the women, the number of times the experiment was conducted, the rate of success and failure, the type of infertility, and the number of oocytes induction, while the duration of sterility was affected by positive values of IgG and lupus coagulant antibodies. There is no need for a routine antiphospholipid assay for female candidates for IVF, and when it is confirmed, treatment is required by Anticoagulants.
抗磷脂抗体的发病率及其对体外受精结果的影响
不孕不育问题在全世界都很普遍。试管婴儿仍然是应用最广泛的辅助生殖技术。胚胎植入失败是不明原因不孕症和复发性流产的常见原因,因此,抗磷脂抗体与体外受精和胚胎移植后胚胎植入失败之间的关系是生育医学中必须研究的一个重要问题。 2017年6月至2021年6月,医学院附属医院检验科开展了一项回顾性和前瞻性(双向)队列研究。样本量为1000人,其中900人为回顾性研究(2017-2020年),100人为前瞻性研究(2020-2021年)。收集的数据包括患者的人口统计学特征、生育类型和持续时间以及抗磷脂抗体值。纳入标准--年龄小于40岁、接受体外受精的女性;在回顾性研究中,接受体外受精且有抗体数据、磷脂阳性、和/或抗心磷脂阳性、和/或B2糖蛋白I阳性的患者,以及以超声检查出现妊娠囊作为妊娠标准的患者。我们在一项队列研究中为对照组(20 名健康女性)进行了 PTT LA 试验,然后进行了 PTT LA 试验和混合试验,如果未进行校正,其值被视为阳性。PTT LA 试验是一项筛查试验。 妇女的平均年龄为 31.91 岁,上次试验中辅助受精引产的成功率为 52.8%,抗心磷脂 IgG 患病率为 4.4%,抗心磷脂 IgM 患病率为 2.6%,狼疮抗凝物患病率为 4%。抗心磷脂值与妇女的年龄、实验次数、成功率和失败率、不孕类型和卵母细胞诱导数量之间没有关系,而不育持续时间则受 IgG 和狼疮凝血因子抗体阳性值的影响。 对于试管婴儿的女性候选者来说,没有必要进行常规的抗磷脂检测,一旦确诊,需要使用抗凝剂进行治疗。
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