Background: Unexplained female infertility is a devastating health problem that has become increasingly prevalent worldwide with no specific explanation despite comprehensive evaluations. Recent data suggest that serum autoimmune antibodies are frequently found in patients with unexplained female infertility. Objectives: This study aims to identify the prevalence of common autoantibody abnormalities in females with unexplained infertility in Saudi Arabia. Methods: A cross-sectional study was conducted on female patients with unexplained infertility sequentially referred to the allergy and immunology clinic at King Abdulaziz University Hospital (KAUH). Demographics, clinical characteristics, and 12 common autoantibody immunological tests were described as frequency and percentage. The chi-square test was applied to evaluate any associations. Results: A total of 119 females with unexplained infertility were studied; of those, 97 (81.5%) had secondary infertility. Their average age was 33.9 ± 5.6 years ranging from 23 to 49 years. The overall prevalence of a high level of at least one autoantibody (above the normal range) was 84%. The predominant high autoantibodies were antithyroglobulin in 42 (35.3%), antithyroid microsomal in 41 (34.5%), beta 2 glycoprotein IgM in 40 (33.6%), antigliadin IgA in 32 (26.9%), antinuclear in 22 (18.5%), and anticardiolipin IgM in 18 (15.1%) of the participants. The following significant associations were found in our study: secondary infertility with beta 2 glycoprotein (p = 0.022), age with antithyroglobulin (p = 0.027), and the number of pregnancies with anti-tissue transglutaminase IgG and antigliadin IgA (p = 0.015 and p = 0.043, respectively). Conclusion: A high level of at least one autoantibody was detected in the majority of females with unexplained infertility. Antithyroid, antiphospholipid, antigliadin, and antinuclear autoantibodies were the most common autoantibodies. These findings may encourage autoantibody screening in infertile females to discover any potential immunopathology in further clinical studies.

Background: While the link between foods and chronic spontaneous urticaria (CSU) is controversial, many immunological mechanisms have been proposed to establish a causal relationship. Objective: To explore the potential benefit of avoiding immunoglobulin G (IgG)-mediated food hypersensitivity as a triggering factor in a case with CSU.History: The patient is a 50-year-old woman who complained of CSU for 1 and half year, which responded partially and temporarily to antihistamine medications. Of interest, it started 6 months after she followed an oat-rich diet. Her Urticaria Activity Score 7 was 23 out of 40. Results: Specific immunoglobulin E responses to common food and inhalant allergens were negative. A food-specific IgG antibody test was conducted, and it was mainly elevated for chicken eggs, rye, sweet pepper, gluten, garlic, wheat, and pineapple. Avoiding these foods had a curative effect on the CSU over a 2-month period. Conclusion: To the best of our knowledge, this is the first case report of symptoms of CSU that resolved after identifying and avoiding food items with IgG antibodies. Furthermore, well-controlled studies are advocated to verify the potential role of IgG food hypersensitivity in the pathogenesis of CSU.