Cecilia Beatrice Chighizola1,2,3, Maria Gabriella Raimondo3,4, Pier Luigi Meroni5,6,7. 1. Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, via Zucchi 18, 20095 Cusano Milanino, Milan, Italy. 2. Allergology, Clinical Immunology and Rheumatology Unit, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy. 3. Department of Clinical Sciences and Community Health, University of Milan, via Francesco Sforza 35, 20122, Milan, Italy. 4. Department of Rheumatology, ASST Istituto Gaetano Pini & CTO, Piazza Cardinal Andrea Ferrari 1, 20122, Milan, Italy. 5. Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, via Zucchi 18, 20095 Cusano Milanino, Milan, Italy. pierluigi.meroni@unimi.it. 6. Department of Clinical Sciences and Community Health, University of Milan, via Francesco Sforza 35, 20122, Milan, Italy. pierluigi.meroni@unimi.it. 7. Department of Rheumatology, ASST Istituto Gaetano Pini & CTO, Piazza Cardinal Andrea Ferrari 1, 20122, Milan, Italy. pierluigi.meroni@unimi.it.
Abstract
PURPOSE OF REVIEW: This review focuses on the relationship between anti-phospholipid antibodies (aPL) and female infertility by addressing three key questions: (i) how can aPL induce women's infertility?; (ii) are aPL more prevalent among infertile than fertile women?; (iii) do aPL-positive women display reduced fertility? RECENT FINDINGS: According to experimental data, aPL impair female fertility interfering with endometrial decidualization thus with implantation. Some aPL tests are more frequently detected among infertile women compared to controls; the association between aPL and assisted reproduction techniques outcome is not supported by most studies. Two reports suggest a decreased ovarian reserve among aPL-positive patients, while fertility is preserved in women with systemic lupus erythematosus, commonly associated with aPL positivity. Pregnancy rates drop after diagnosis and lupus women have fewer children than wished, due to many disease-related factors. While awaiting definitive conclusions on the relationship between aPL and infertility, rheumatologists should properly counsel female patients to safeguard fertility.
PURPOSE OF REVIEW: This review focuses on the relationship between anti-phospholipid antibodies (aPL) and female infertility by addressing three key questions: (i) how can aPL induce women's infertility?; (ii) are aPL more prevalent among infertile than fertile women?; (iii) do aPL-positive women display reduced fertility? RECENT FINDINGS: According to experimental data, aPL impair female fertility interfering with endometrial decidualization thus with implantation. Some aPL tests are more frequently detected among infertile women compared to controls; the association between aPL and assisted reproduction techniques outcome is not supported by most studies. Two reports suggest a decreased ovarian reserve among aPL-positive patients, while fertility is preserved in women with systemic lupus erythematosus, commonly associated with aPL positivity. Pregnancy rates drop after diagnosis and lupus women have fewer children than wished, due to many disease-related factors. While awaiting definitive conclusions on the relationship between aPL and infertility, rheumatologists should properly counsel female patients to safeguard fertility.
Authors: María Del Carmen Velarde-Ochoa; Jorge Antonio Esquivel-Valerio; David Vega-Morales; Cassandra Michele Skinner-Taylor; Dionicio Ángel Galarza-Delgado; Mario Alberto Garza-Elizondo Journal: Reumatol Clin Date: 2014-05-10
Authors: A A Gasparin; L Souza; M Siebert; R M Xavier; R M S Chakr; P E Palominos; J C T Brenol; O A Monticielo Journal: Lupus Date: 2015-07-28 Impact factor: 2.911
Authors: Olivio B Malheiro; Carolina P Rezende; Ana Luiza L Rocha; Helen L Del Puerto; Gilda A Ferreira; Fernando M Reis Journal: Gynecol Endocrinol Date: 2014-06-05 Impact factor: 2.260