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BACKGROUND: Obstetric morbidities represent a common hallmark manifestation of antiphospholipid syndrome (APS), with the recurrent loss of pregnancy as the main complication. The presence of antiphospholipid antibodies (APA) and its potential impact have not been established yet in infertile women seeking assisted reproduction technologies in Syria.This study aims to determine the prevalence of anticardiolipin antibodies (aCL) and lupus anticoagulation (LAC) and their association with age and the In vitro fertilization (IVF) outcomes in a large sample of Syrian women. MATERIALS AND METHODS: The electronic patients' records were screened and relevant data extraction was performed retrospectively. The study included 876 women who had IVF between January 2012 and January 2020 in a tertiary care hospital. RESULTS: The prevalence of APA among the included women was less than 1%. Only 5 patients had positive APA. No correlation was found between the APA levels and age. Additionally, the APA did not have an impact on neither the IVF outcomes nor the number of IVF cycles. CONCLUSION: the added value of APS antibodies' screening could be considered very modest when compared to its financial burden on patients since it has a very low prevalence in women having IVF.
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Introduction Thyroid autoimmune (TAI) disease with a prevalence varying between 5 and 15%, represents the most common endocrine disorder in women with reproductive age. Not only is TAI disease five to 10 folds more common in women than men but also TAI diseases is often undiagnosed because it may be present without overt thyroid dysfunction for several years. Studies found an increased prevalence of TAI in women referred to fertility clinics compared with normal population. In this analysis we aimed to study the prevalence of TAI among women seeking fertility care in Damascus, Syria in order to understand its clinical and public health importance in population. Methods This study is a retrospective cross-sectional study on women patients seeking fertility care at Orient Hospital, Damascus city, Syria from April 2011 to March 2018. A total of 2526 women, with available biochemical data of anti-thyroid antibodies (anti-TPO) and anti-thyroglobulin antibodies (anti-TG) were included in our study. Thyroid stimulating hormone (TSH) titers data were also included in the statistical analysis. Results TAI was found positive in 559 patients (22.1%) of our studies population. TAI was more prevalent in patients with abnormal TSH levels. Conclusion Thyroid autoimmunity prevalence in women seeking fertility care in Damascus, Syria was 22.1% which is significantly higher than normal population. Further studies are needed to assess the relation of these antibodies in thyroid, gynecological and other factors for the Syrian population.
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Pregnancy produces profound physiological changes that increase in significance as it progresses. These changes include hormonal changes, metabolic changes, increases of plasma volume up to 50%, alterations to the balance of the coagulation system in favour of clotting, and GFR increases to a peak 50% above prepregnancy levels. Since healthy physiological changes occur during pregnancy, different reference intervals may be needed. First antenatal screens usually include Complete blood count, Blood group and antibody screen, rubella antibody status, syphilis serology, Hepatitis B serology and HIV abs testing. Additional testing in early pregnancy may be added to the first antenatal screen such as varicella, Chlamydia and vitamin D tests. The most important test in the second antenatal testing screen is gestational diabetes screening and protein detection in urine to rule out preeclampsia. Screening for Down syndrome, other chromosomal abnormalities and neural tube defects is recommended for all pregnant women above the age of 35 years. Additionally, 37 weeks into pregnancy, a swab to detect Group B streptococcal (GBS) infection is recommended.
