The impact of antinuclear antibody levels on pregnancy outcomes of in vitro fertilization-embryo transfer
Objective To investigate the impact of antinuclear antibody(ANA)levels on the pregnancy outcomes of in vitro fertilization(IVF)-embryo transfer(ET)and to explore the efficacy of immunological anticoagulant therapy.Methods The data of infertility patients undergoing IVF-ET in the Reproductive Endocrinology Department of Zhejiang Provincial People's Hospital from January 2018 to November 2022 were retrospectively analyzed,including 818 IVF cycles and 673 ET cycles.Based on ANA titers,patients were categorized into ANA negative group,ANA weak-positive group(titer 1:32),and ANA positive group(titer ≥1:100),the ANA positive group further divided into low titer positive group(titer ≥1:100 and＜1:320)and high titer positive group(titer ≥1:320).The ovum retrieval rate,fertilization,and embryo quality were compared among the groups,the impact of ANA levels on the IVF-ET outcomes was analyzed,and the efficacy of immunological anticoagulant therapy for patients with weakly-positive and positive ANA titers was assessed.Results The ovum retrieval rate in the ANA positive group was lower than that in the ANA negative group(72.79％vs.75.90％,P＜0.05).There were no statistically significant differences in the rates of cleavage and D3 superior embryo rate among the ANA negative group,ANA weakly-positive group,and ANA positive group(all P＞0.05).The ovum retrieval rate,D3 superior embryo numbers,and D3 superior embryo rate were lower in the high titer positive group compared to the low titer positive group[67.18％vs.75.37％,2.00(1.00,4.00)vs.3.00(2.00,5.00),and 42.39％vs.58.62％;all P＜0.05].The IVF fertilization rate was lower in the anti-centromere antibody(ACA)positive group compared to the SSA antibody positive group(48.41％vs.76.54％,P＜0.01).There were no significant differences in the hCG positivity rate,clinical pregnancy rate,embryo implantation rate,clinical pregnancy miscarriage rate,and live birth rate among the ANA negative group,ANA weakly-positive group,and ANA positive group after ET(all P＞0.05).There were no significant differences in above indicators between the ANA negative untreated group and the ANA positive treated group(all P＞0.05);and between the ANA weakly-positive treatment group and the untreated group(all P＞0.05).Conclusion High titer positive ANA has an adverse effect on ovum retrieval,fertilization,and embryo development in infertile patients receiving IVF-ET,and there is a significant impact on fertilization in ACA-positive cases.Immunological anticoagulant therapy may not significantly improve the outcomes of IVF-ET in patients with weakly-positive ANA.
万方数据
维普
