Iana Leineman
E.E. Eichwald of North-Western State Medical University , RussiaTitle: The role of assisted reproductive technologies in transformations Apl-positive women into apl syndrome
Abstract
Background
More and more often during the investigations of female infertility antiphospholipid antibodies (APLA) positivity is detected. The aim of our work was to study the effect of APLA on outcomes of assisted reproductive technologies (ART) and to evaluate the role of ART in transformation of APLA positivity into criterial antiphospholipid syndrome (APS).
Methods
We examined 50 APLA positive women, who planned pregnancy. Half of them were with infertility and underwent ART. A control group included 25 women with physiological pregnancy.
Results
All patients have medium titer of APLA. In the group of ART 50% had more than 3 ART procedures. Unexplained abortions before 10th week of gestation were in 11 women, unexplained deaths at or beyond the 10th week – in 5 women, premature birth before the 34th week – in 3 women. 19 pregnancies ended with a live birth. 3 patients had venous thrombosis. 2 of them were double and 1 triple positive APLA.
5 patients flared during pregnancy or puerperium, 3 of them – UCTD, 2 of them – SLE with involvement of kidney, skin and joints. All of them were ANA positive at the beginning of pregnancy, and 2 of them had low titer of anti-dsDNA antibodies and hypocomplementemia. Obstetric complications were observed in 9 out of the 19 successful pregnancies, including 7 cases of preeclampsia and 2 cases of eclampsia. In comparison to the control group: unexplained abortions before 10th week of gestation were observed in 7 APLA positive women with physiological pregnancy, obstetric complications - in 3 out of the 25, no episodes of thrombosis and flares of autoimmune diseases.
Conclusions
At the end of study from 25 APLA positive women who underwent ART 10 women had criterial obstetric APS and 3 criterial thrombotic APS. Serological activity seems important determinants of ART results and pregnancy outcomes.
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