High levels of anticardiolipin antibodies in patients with abnormal embryo morphology who attended an in vitro fertilization program.

PROBLEM: Recently, it has been suggested that anticardiolipin antibodies (ACAs) may serve as possible markers for reproductive failure. The association between ACAs and embryo morphology in patients undergoing in vitro fertilization (IVF) was investigated. METHOD OF STUDY: This prospective study comprised 117 patients with either tubal factor or unexplained infertility. Embryo morphology was blindly scored from I to IV according to blastomere regularity and the presence of fragments. Anticardiolipin antibodies (immunoglobulin [Ig] G and IgM) were detected. RESULTS: Anticardiolipin antibodies were found in 26 (50%) of the 52 patients with abnormal morphology, compared with 13 (20%) of the 65 patients with normal embryo morphology (P = 0.001). No statistically significant differences were found between the prevalence of ACAs among patients with tubal factor and those with unexplained infertility (29.6% and 36.5%, respectively). CONCLUSIONS: Our study shows an association between embryo morphology and the presence of ACAs. This association may explain the low implantation rate and early pregnancy loss in patients with ACAs.

Vaccination against hepatitis B in a general hospital in Israel: antibody level before vaccination and immunogenicity of vaccine.

We offered hepatitis B vaccine (Heptavax B) to 809 of the health care personnel of a 650-bed regional hospital; 290 accepted the offer. Anti-HBs measurement was done by enzyme immunoassay (AUSAB EIA, Abbott, UK) and expressed in mIU/ml. Seroconversion was determined at a level of 2.1 mIU/ml. Of 290 employees 58 (20%) were found positive for hepatitis B antibodies before vaccination. Of the laboratory technicians, 40.9% were found positive for antibodies before vaccination, as were 26.5% of nurses and 10.9% of physicians. Among vaccine recipients 35.8% responded after the first dose, 86.6% after the second and 92.7% after the third. Seventeen workers (7.3%) were nonresponders, of whom 14 received the whole vaccine series. There was no difference in immune responses to the vaccine between men and women. The present study confirms the relatively high prevalence of HBV infection in health care workers. Furthermore, vaccination of employees has been highly effective and well tolerated. The present data, therefore, support the introduction of active vaccination against HBV in health care workers in Israel.