Intrafollicular fluid antigamete antibodies in infertile patient candidates for ICSI

Immunologic disturbances must be considered as a major cause of infertility. Antigamete antibodies like antisperm antibodies [ASA] and to anti-zona antibodies [AZA] seem to be implicated in the etiology of infertility. These antibodies affect fertilization and embryo development. It is important to screen these antibodies in infertile women who are candidates for in-vitro fertilization [IVF], because the presence of these antibodies may switch the treatment from IVF to intra-cytoplasmic microinjection [ICSI]. The objective of this study was to determine the presence of ASA and AZA in the follicular fluids [FF] of women who sought candidacy for ICSI. In this prospective study, the follicular fluids of 96 infertile women [20 to 39 years old, mean 31.5 +/- 5.1], who were candidates for ICSI, were evaluated. According to the etiologies, 80 women had explained whereas 16 had unexplained infertility. All the follicular fluids were evaluated for the presence of ASA by ELISA and Sperm MAR test and also for the presence of AZA by ELISA. The data were analyzed by Chi-square test using SPSS soft-ware and the significance level was considered p<0.05. According to the results of ELISA and Sperm MAR test, none of the patients had ASA in their follicular fluids. However, twenty samples [20.8%] were positive for AZA. In patients with unexplained infertility, autoantibodies to zona pellucida were significantly higher in the follicular fluid than the group with proven etiologies for infertility [p=0.001]. The low incidence of ASA and the high incidence of AZA in the infertile women in this study, especially in women with unexplained infertility in Iran have to be considered seriously. Determination of AZA is highly recommended in the evaluation of infertile couples, especially those with unexplained infertility

Anti-zona pellucida antibodies in infertile patients in relation to multiple puncture of ovaries and unexplained infertility

Auto antibodies to zona-pellucida [AZA] seem to be important autoantibodies implicated in reproduction, with substantial role in both endocrine and reproductive functions of the human ovary. There are some debates on the relation of AZA with infertility, repeated In Vitro Fertilization [IVF] attempts, and outcome of it. In this study, we assessed the presence of AZA in the follicular fluids [FFs] of women who underwent intra cytoplasmic sperm injection [ICSI], in relation to etiology of infertility and multiple puncture of ovaries. In this prospective study, follicular fluids were evaluated from 96 infertile women, [19-40 years old, 31.5 +/- 5.1], who were c and idates for ICSI based on the etiology of infertility. From these 80 women had explained infertility whereas 16 had unexplained infertility. All FFs were evaluated for presence of AZA by ELISA test. Twenty patients [20.8%] were positive for AZA in follicular fluid. In patients with unexplained infertility, AZA antibody in follicular fluid, was significantly higher than the group with proven etiology of infertility [p=0.001]. In addition, 20.4% of patients who had been punctured previously showed AZA in their FFs which is statistically similar to the patients who were punctured for the first time. The high incidence of AZA in infertile women, especially women with unexplained infertility has to be considered. Relation of the presence AZA and repeated puncture of ovaries is still debatable. Determinations of AZA are highly recommended in evaluation of infertile couples especially in patient with unexplained infertility