Autoantibodies and antisperm antibodies in sera and follicular fluids of infertile patients; relation to reproductive outcome after in-vitro fertilization.

Immune reactions have effects at various concentrations in the reproductive process and autoantibodies may have an impact on fertility and the outcome of assisted conception. We measured the prevalence of and relation between antibodies to smooth muscle, nuclear, phospholipid and sperm antigens, and concentrations of immunoglobulins G, M and A and complement components C3 and C4, in the sera and follicular fluids of women with unexplained infertility (n = 30), endometriosis (n = 20), tubal infertility (n = 50) and the sera of 20 normal non-pregnant women. We assessed fertilization and successful pregnancy rates in relation to antibody status of infertile women after in vitro fertilization. All antibodies had a higher prevalence in infertile women compared with controls and this was significant for smooth muscle antibody in endometriosis (P < 0.05); anticardiolipin antibody in tubal infertility (P < 0.05); and antisperm antibody in all types of infertility (P < 0.001). There was no relation between presence of specific antibodies in serum or between serum and follicular fluids. Total biochemical pregnancy rate was higher with endometriosis (P = 0.05) but clinical pregnancy and live birth rates did not differ between groups or in relation to antibody status. Significant differences in immunoglobulin and complement components occurred in women with and without successful biochemical pregnancy.