抗心磷脂抗体对体外受精—胚胎移植的影响

目的探讨血清抗心磷脂抗体对体外受精－胚胎移植（ＩＶＦ－ＥＴ）中胚胎着床的影响。方法采用酶联免疫吸附法（ＥＬＩＳＡ法）对１９９４年１１月至１９９６年５月共１５０个ＩＶＦ－ＥＴ周期（１５０例）中女性血清中抗心磷脂抗体（ＡＣＡ－ＩｇＧ、ＩｇＭ类）进行测定,同时观察ＩＶＦ－ＥＴ周期的妊娠结局。结果２１个ＡＣＡ阳性周期的临床妊娠率为９．５％,明显低于１２９个ＡＣＡ阴性周期的临床妊娠率２６．３％（Ｐ＜０．０５）。１５例生化妊娠者的血清ＡＣＡ阳性率为２０．０％,９９例未妊娠者的ＡＣＡ阳性率为１６．２％,两者ＡＣＡ阳性率均高于３６例临床妊娠者的５．６％（Ｐ＜０．０５）。生化妊娠者与未妊娠者的ＡＣＡ阳性率比较,差异无显著性（Ｐ＞０．２５）。结论女性患者体内ＡＣＡ可能干扰了ＩＶＦ－ＥＴ中胚胎着床和胚胎着床后的早期发育,体内自身抗体的存在也是ＩＶＦ－ＥＴ失败的原因之一。

A study on the relationship between serum anticardiolipin antibody and embryo implantation in an in vitro fertilization and embryo transfer program

Objective To study the role of serum anticardiolipin antibody in embryo implantation in an in vitro fertilization and embryo transfer program.Methods 150 in vitro fertilization and embryo transfer (IVF ET) treatment cycles from Nov.1994 to May, 1996 were studied. Serum anticardiolipin antibody was measured by enzyme linked immunosorbent assay (ELISA) , and the clinical pregnancy outcome observed.Results Lower pregnancy rate 9.5% was found in 21 cycles of anticardiolipin antibody seropositive women compared with 26.3% in 129 cycles of anticardiolipin antibody seronegative women ( P <0.05). Patients with biochemical pregnancy and no pregnancy had seropositive anticardiolipin antibody in 20.0% and 16.2% compared with 5.6% in the patients with clinical pregnancy ( P <0 05). Conclusions Failure of embryo implantation is associated with many factors. Our study demonstrated the serum anticardiolipin antibody in patients may play a part in embryo implantation and very early postimplantation loss.