Reproductive failure because of autoantibodies: Unexplained infertility and pregnancy wastage

Norbert Gleicher*, Albert El-Roeiy, Edmond Confino, Jan Friberg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

142 Scopus citations

Abstract

Abnormal polyclonal B cell activation has been demonstrated in patients with endometriosis. To determine whether the noted -B cell abnormalities were primarily a feature of the disease endometriosis or its manifestations of infertility and pregnancy wastage, we investigated antibody profiles in 26 female patients with unexplained infertility (group A) and 24 patients with unexplained pregnancy wastage (group B) but without documented endometriosis. Group A and B patients exhibited an unusual incidence of gammopathies (10 of 26 patients in group A and 11 of 24 in group B), with a majority representing immunoglobulin M gammopathies. Mean immunoglobulin M values were significantly elevated in both groups (p < 0.03 and p < 0.05, respectively, Student t test), whereas immunoglobulin G was significantly increased only among group B patients (p < 0.05, Student t test). Lupus anticoagulant by tissue thromboblastin inhibition test was abnormally elevated in 2 of 26 group A and 2 of 24 group B patients. Activated partial thromboplastin time values were abnormal in only 3 of 26 group A and 2 of 24 group B women. Immunoglobulin G, immunoglobulin M, and immunoglobulin A autoantibodies to two phospholipid antigens, five histones, and four polynucleotide autoantibodies were detected in 23 of 26 (88%) group A patients and 17 of 24 (70.8%) group B patients. We conclude that some patients with unexplained infertility and pregnancy wastage suffer from polyclonal B cell activation. It is therefore tempting to speculate that autoantibody abnormalities may be causally related to infertility and pregnancy loss.

Original languageEnglish (US)
Pages (from-to)1376-1385
Number of pages10
JournalAmerican journal of obstetrics and gynecology
Volume160
Issue number6
DOIs
StatePublished - Jun 1989

Keywords

  • B cell abnormality
  • infertility
  • polyclonal activation
  • pregnancy wastage

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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