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. 2013 Oct 5:11:98.
doi: 10.1186/1477-7827-11-98.

A retrospective study on IVF/ICSI outcome in patients with anti-nuclear antibodies: the effects of prednisone plus low-dose aspirin adjuvant treatment

Qing Zhu  1 , Li Wu, Bo Xu, Mei-Hong Hu, Xian-Hong Tong, Jing-Juan Ji, Yu-Sheng Liu
Affiliations

A retrospective study on IVF/ICSI outcome in patients with anti-nuclear antibodies: the effects of prednisone plus low-dose aspirin adjuvant treatment

Qing Zhu et al. Reprod Biol Endocrinol. .

Abstract

Background: Anti-nuclear antibodies (ANA) are suspected of having relevance to adverse reproductive events.

Methods: This study aims to investigate the potential effect of ANA on IVF/ICSI outcome and the therapeutic role of prednisone plus low-dose aspirin (P + A) adjuvant treatment in ANA + patients. The first IVF/ICSI cycles without P + A of sixty-six ANA + women were enrolled as the ANA + group, and the 233 first IVF/ICSI cycles of matched ANA- women served as the ANA- group. The ANA + group was divided into the Titre < =1:320 subgroup and the Titre > 1:320 subgroup. Twenty-one ANA + women with adverse outcomes in their first cycles (ANA + cycles without P + A) received P + A adjuvant treatment for three months before the second IVF/ICSI cycle (ANA + cycles with P + A). The clinical characteristics and the IVF/ICSI outcomes were compared, respectively, between 1) the ANA + group and the ANA- group, 2) the Titre < =1:320 subgroup and the Titre > 1:320 subgroup, and 3) the ANA + cycles without P + A and the ANA + cycles with P + A.

Results: No significant differences were observed between each of the two-group pairs in the clinical characteristics. The ANA + group exhibited significantly lower MII oocytes rate, normal fertilisation, pregnancy and implantation rates, as well as remarkably higher abnormal fertilisation and early miscarriage rates. The Titre < =1:320 subgroup's IVF/ICSI outcomes were as poor as those of the Titre > 1:320 subgroup. After the P + A adjuvant treatment, the number of two pro-nuclei, perfect embryos and available embryos, and the implantation rate increased significantly.

Conclusions: These observations suggest that ANA could exert a detrimental effect on IVF/ICSI outcome that might not be titre-dependent, and P + A adjuvant treatment could be useful for ANA + patients. This hypothesis should be verified in further prospective randomised studies.

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Figures

Figure 1
Figure 1
Pregnancy outcome in IVF/ICSI cycles. (a) The IVF/ICSI outcome in the ANA + group and the ANA-group. In the ANA + group, the implantation rate (9.09% vs. 36.8%) and the clinical pregnancy rate (17.3% vs. 56.5%) decreased significantly, and the early miscarriage rate (44.4% vs. 9.62%) increased markedly more than in the ANA- group. (b) The IVF/ICSI outcome in the Titre ≤1:320 subgroup and the Titre > 1:320 subgroup. No significant differences were found between the two subgroups in the implantation rate, the clinical pregnancy rate and the early miscarriage rate. * P < 0.05, ** P < 0.01.
See this image and copyright information in PMC

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