Impact of Antiphospholipid Antibodies on Intracytoplasmic Sperm Injection Outcome

Abstract

Introduction and Aim: The effect of antiphospholipid syndrome on pregnancy is extensively discussed but the debate is still ongoing. This debate increased when the association was examined after assisted reproductive techniques for infertility. The current work aimed to evaluate the influence of Antiphospholipid antibodies in patient undergo first cycle of intracytoplasmic sperm injection. Subjects and Methods: The study comprised 130 of infertile females, who were scheduled for the first ICSI cycle. Before protocol selection, basal hormonal assay was performed and included FSH, LH, E2, prolactin and AMH. Plasma concentration of anti-phospholipids (APAs) was measured. Then, females were categorized into groups according to APAs (positive and negative groups). After ICSI, the clinical pregnancy was confirmed by presence the gestational sac or sac with positive pulsation. Ongoing pregnancy was recognized if the pregnancy continued after 12 weeks of the gestation and clinical miscarriage if pregnancy terminated before 12 weeks of gestation. Results: All females were in their reproductive age (18- 40 years). Their fertility duration ranged between 1 and 7 years, and it was of primary type among 96 women. The long agonist protocol was used for 72 women and the antagonist protocol done for 58 women. The Antiphospholipid antibodies were positive among 27 females (20.8%), and there was no significant difference between APL positive and negative groups regarding pregnancy results (either chemical, clinical, incidence of abortion or ongoing pregnancy after 12 weeks) for all females. However, in women with positive clinical pregnancy, the rate of abortion was significantly increased in patients with APL- positive than negative females (66.7% vs 26.7%). Conclusion:  The presence of APA was associated with higher significant abortion rate after the first cycle of ICSI. Thus, screening for APA in women with infertility scheduled for assisted reproduction is recommended.