Female Infertility and Serum Auto-antibodies: a Systematic Review.
On average, 10 % of infertile couples have unexplained infertility. Auto-immune disease (systemic lupus erythematosus, anti-phospholipid syndrome) accounts for a part of these cases. In the last 20 years, aspecific auto-immunity, defined as positivity of auto-antibodies in blood sample without clinical or biological criteria for defined diseases, has been evoked in a subpopulation of infertile women. A systematic review was performed (PUBMED) using the MESH search terms "infertility" and "auto-immunity" or "reproductive technique" or "assisted reproduction" or "in vitro fertilization" and "auto-immunity." We retained clinical and physiopathological studies that were applicable to the clinician in assuming joint management of both infertility associated with serum auto-antibodies in women. Thyroid auto-immunity which affects thyroid function could be a cause of infertility; even in euthyroidia, the presence of anti-thyroperoxydase antibodies and/or thyroglobulin are related to infertility. The presence of anti-phospholipid (APL) and/or anti-nuclear (ANA) antibodies seems to be more frequent in the population of infertile women; serum auto-antibodies are associated with early ovarian failure, itself responsible for fertility disorders. However, there exist few publications on this topic. The methods of dosage, as well as the clinical criteria of unexplained infertility deserve to be standardized to allow a precise response to the question of the role of serum auto-antibodies in these women. The direct pathogenesis of this auto-immunity is unknown, but therapeutic immunomodulators, prescribed on a case-by-case basis, could favor pregnancy even in cases of unexplained primary or secondary infertility.
['Deroux|Alban|A|http://orcid.org/0000-0002-9098-7368', 'Dumestre-Perard|Chantal|C|', 'Dunand-Faure|Camille|C|', 'Bouillet|Laurence|L|', 'Hoffmann|Pascale|P|']
D000311:Adrenal Glands D000974:Antibodies, Antinuclear D017152:Antibodies, Antiphospholipid D001323:Autoantibodies D015551:Autoimmunity D004717:Endometrium D005260:Female D005307:Fertilization in Vitro D006801:Humans D007247:Infertility, Female D010053:Ovary D011247:Pregnancy D027724:Reproductive Techniques, Assisted D014327:Trophoblasts
Infertility Serum auto-antibodies Auto-immunity Reproductive technique Assisted reproduction Immunomodulator Anti-nuclear antibodies Anti-phospholipid antibodies