Endocrine Abstracts

Introduction: The presence of antiphospholipid antibodies is associated pathogenically with thrombotic vascular events and resulting pregnancy complications. Studies support that antiphospholipid antibodies (aPL) impair female fertility by interfering with endometrial decidualization and implantation. This meta-analysis aims to determine the prevalence of aPL in women undergoing assisted reproductive techniques (ART) for in Vitro Fertilization and Embryo Transfer (IVF-ET).

Material and methods: A systematic review of the literature was performed in PubMed regarding observational studies which reported prevalence of aPL among women undergoing ART for IVF-ET and implantation rate was included in their outcome. Studies included women failed to conceive and control women who conceived. A prospectively registered with structured search strategy was employed. The extracted data (patients’ and control characteristics and outcomes) were transferred in a standardized form. Risk of bias was assessed by employing Newcastle-Ottawa Score and meta-analysis was performed only if the design of the studies were similar enough for data to be pooled together.

Results: Our systematic review yielded 14 studies, evaluating 3462 women of reproductive age. The prevalence of aPL among women experiencing IVF failure was compared with its prevalence among women who conceived following IVF (4 studies) or with matched women of reproductive age (11 studies). All results consistently showed significantly higher levels of aPL among women experiencing IVF failure. Our results were heterogeneous, due to differences in study designs and inclusion criteria. However, all included studies presented consistent results, supporting our protocol hypothesis.

Conclusion: These results strongly suggest that the presence of antiphospholipid antibodies in women ART for IVF-ET may reduce the rate of the implantation compared to controls and consequently impair the fertilization rate and pregnancy outcome.