Influence of Antiphospholipid Antibodies on IVF-ET Outcome in Women Referred for IVF-ET / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: The present study was designed to investigate if antiphospholipid antibodies (aPL) could affect the pregnancy outcome in women undergoing in vitro fertilization and embryo transfer (IVF-ET). MATERIALS AND METHODS: From January 1997 to June 2001, 9 women with aPL who underwent IVF- ET were studied. Forty-five women without aPL who underwent IVF-ET served as control. Anticardiolipin antibody (aCL) IgG, IgM, lupus anticoagulant (LA) were assayed with use of standardized enzyme linked immunosorbent assays (ELISA) and dilute Russell's viper venom time (dRVVT) test. Long protocol of gonadotropin-releasing hormone agonist (GnRH-a) was used for controlled ovarian hyperstimulation (COH) in all patients. Statistical analysis was performed using Student's t-test, Fisher's exact test, and x2 test as appropriate. Statistical significance was defined as p<0.05. RESULTS: There were no significant differences between the study and control groups in patient characteristics such as age, infertility duration, hormonal profile, cause of infertility and number of previous IVF attempts. There were also no significant differences between two groups with respect to clinical response to COH and IVF results such as number of retrieved oocytes, fertilization rate, number of embryos frozen and number of embryos transferred. The clinical pregnancy rate per cycle seemed to be higher in the study group than in the control group (25.0% vs 14.9%), however, the difference was not statistically significant. Miscarriage rate per clinical pregnancy was significantly higher in the study group at 67.0% (4/6) compared with 29.4% (5/17) in the control group. Delivery rate per clinical pregnancy was significantly lower in the study group at 16.7% (1/6) compared with 58.8% (5/17) in the control group. CONCLUSION: Women with aPL undergoing IVF-ET may have similar IVF outcome compared with women without aPL, except miscarriage rate per clinical pregnancy.