Anticardiolipin Antibodies and Lupus Anticoagulants among Women Undergoing In Vitro Fertilization in Jamaica

Abstract

The aims of this study were to evaluate the effect of anticardiolipin antibody (aCL) and lupus anticoagulant (LA) on the outcome of the in vitro ferlitization (IVF) cycles and to determine the prevalence of these antibodies in infertile women seeking IVF in Jamaica. Methods: A retrospective cohort study was performed to determine if screening patients for aCL and LA had any significant impact on the outcome of the IVF process. Each patient's hospital record, between March 2000 and March 2010, was collected and the relevant data extracted. Results: The prevalence of aCL in this cohort of Jamaican women was moderate/high positive 3.88%, low positive 0.68% and those with negative aCL results 95.4%. The prevalence of women who were LA positive was 4.1% and 0.9% of the women were positive for both LA and aCL. Of the patients who were LA and/or aCL positive, eight out of 30 patients (26.7%) had a positive pregnancy test in comparison to 61 out of 181 patients (33.7%) who were LA and/or aCL negative (p = 0.5787). Conclusion: The prevalence of positive aCL and/or LA in infertile women seeking IVF in Jamaica is 7.76%. The presence of these antibodies did not affect the pregnancy rate of these women nor did it demonstrate an increased risk for IVF cycle cancellation or ovarian hyperstimulation syndrome. Screening women undergoing IVF for these antibodies is not justified.

Antiphospholipid syndrome and infertility

“…Ying et al 65 116 infertile women positive for aCL 518 infertile women negative for aCL The overall IVF results in the aCL positive group were comparable with patients negative for aCL. DaCosta et al 66 34 aPL positive patients 205 aPL negative controls Of the 30 patients who were LA and/or aCL positive, eight (26.7%) had a positive pregnancy test. Of the controls, 61 out of 181 (33.7%) were LA and/or aCL negative (p ¼ 0.5787).…”

“…No significant difference existed between the total number of IVF attempts including those that succeeded between aPL positive and negative IVF patients. 66 Similarly, Orquevaux and colleagues assessed aPL in women undergoing IVF and associated the presence of aPL to IVF outcome. Pregnancy rate in both groups was similar.…”

The Impact of Autoantibodies on IVF Treatment and Outcome: A Systematic Review

“…Fifteen studies were identified including anti-Phospholipid antibodies and IVF outcome [ 11 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ]. Most of the included studies were of prospective nature, while three of retrospective, one1 case report, and two case series were included.…”

“…Out of 12 cohort studies, 11 employed aPL-negative women as controls [ 11 , 43 , 44 , 47 , 48 , 51 , 52 , 53 , 54 , 55 , 56 ] and one employed women with Lupus as control group [ 46 ]. Regarding cohort studies employing aPL-negative women as controls, seven studies reported on LB/OP rate [ 11 , 43 , 44 , 47 , 53 , 54 , 55 ], ten studies reported on clinical pregnancy rate [ 11 , 43 , 44 , 47 , 51 , 52 , 53 , 54 , 55 , 56 ] and eight studies on miscarriage rate [ 11 , 43 , 44 , 47 , 51 , 52 , 53 , 54 ].…”

“…Regarding cohort studies employing aPL-negative women as controls, seven studies reported on LB/OP rate [ 11 , 43 , 44 , 47 , 53 , 54 , 55 ], ten studies reported on clinical pregnancy rate [ 11 , 43 , 44 , 47 , 51 , 52 , 53 , 54 , 55 , 56 ] and eight studies on miscarriage rate [ 11 , 43 , 44 , 47 , 51 , 52 , 53 , 54 ]. One study reported only on biochemical pregnancy (positive pregnancy test) [ 48 ].…”