Outcomes of assisted reproductive technologies in patients with persistence оf antiphospholipid antibodies


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Objective. To identify the connection between persistence of antiphospholipid antibodies (APLAs) and pregnancy rate in infertile women undergoing assisted reproductive technologies (ART). Materials and methods. The prospective case-control study included 97 couples who presented for infertility treatment with ART programs. The stratification of the patients was the following: group 1 included patients who achieved pregnancy, group 2 included patients without pregnancy. Antibodies of the IgM and IgC classes to cardiolipin, в2-glycoprotein-1 (P2-GP-1), annexin V, phosphatidylserine (PS) and phosphatidylethanolamine (PE) were determined using enzyme-linked immuno-sorbent assay (ELISA). Plasma lupus anticoagulant was detected by Russel Viper Venom Time test. APLAs were determined before ovarian stimulation and 8-12 weeks after it. Hemostasis was assessed using thrombodynamics (TD). Results. In patients of group 2, there was the significantly higher level of criterial (P2-GP-1) and non-criterial IgM antibodies (PS, PE, annexin V). The ALPA level higher than the reference level was revealed twice with 8-12 weeks interval in 18 patients: in 2 patients of group 1 (6.7%) and in 16 patients of group 2 (23.9%) (р=0.04). It was accompanied by non-criterial antibodies persistence (PS, PE and annexin V) with IgM to IgG conversion. The significant correlation between level of antibodies and TD parameters was detected. It was suggestive of association between the APLA level and state of blood coagulation. Conclusion. Persistence of APLAs, especially of the so-called non-criterial antibodies, decreased the chances of pregnancy by 4.34 times (95% CI=1.04; 20.22). The APLA level had a strong correlation with TD parameters showing hypercoagulation and subsequently developed hypocoagulation which in its turn can be one of pathogenetic mechanisms of implantation failures in ART programs.

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作者简介

E. Kraevaya

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kraevaya@oparina4.ru
junior researcher of the Department of Auxiliary Technologies in Infertility Treatment 4 Oparin str, 117997, Moscow, Russia

N. Dolgushina

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: n_dolgushina@oparina4.ru
M.D., Ph.D., M.P.H., Head of R&D Department 4 Oparin str, 117997, Moscow, Russia

I. Menzhinskaya

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: i_menzinskaya@oparina4.ru
Ph.D, senior Researcher of Department of Clinical Immunology 4 Oparin str, 117997, Moscow, Russia

M. Shpilyuk

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: tambovtsevamr@mail.ru
researcher of the Laboratory of Clinical Immunology 4 Oparin str, 117997, Moscow, Russia

O. Beznoshchenko

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: o_beznoshchenko@oparina4.ru
clinical laboratory diagnostician of the Laboratory of Clinical Immunology 4 Oparin str, 117997, Moscow, Russia

L. Krechetova

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: k_l_v_@mail.ru
M.D., head of clinical immunology laboratory 4 Oparin str, 117997, Moscow, Russia

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