Common Autoimmune Antibodies in Unexplained Infertile Female Patients in Saudi Arabia

Abstract

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.

Serum Proteomic Profile of Women Undergoing Assisted Reproduction Technology and its Relation to the Outcome

“…In the study of Sun et al, increased levels of complement C4-B were found in follicular fluid of woman who had recurrent spontaneous abortion (17). Koshak et al, found that in the serum of females with unexplained infertility there were increased levels of Immunoglobins as well as increased levels of proteins of the complement cascade (18).…”

Navigating the Challenges of Gluten Enteropathy and Infertility: The Role of Celiac-Related Antibodies and Dietary Changes

“…A recent cross-sectional study by Koshak et al (2022) revealed some common autoimmune antibodies in unexplained infertility in women. Along with anti-thyroglobulin, anti-thyroid microsomal, beta 2 glycoprotein IgM, and antinuclear antibodies (ANA), antigliadin antibodies IgA and anti-tTG IgA (6.7%) were observed in 26.9% of the investigated women [34]. The authors also established an association between the number of pregnancies and anti-tTG IgG and anti-gliadin IgA.…”

“…The authors also established an association between the number of pregnancies and anti-tTG IgG and anti-gliadin IgA. Anti-tTG was also associated with the number of ICSI [34]. Di Simone et al discussed the role of anti-tTG antibodies in damaging trophoblast via apoptosis.…”

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“…However, in 10-17% of females, no cause is identified (idiopathic infertility) [5]. Despite that, some studies have reported that idiopathic infertility could be a consequence of imbalanced adaptive immunity [5,6] or genetic abnormalities [7].…”