Diagnostic evaluation of women experiencing repeated in vitro fertilization failure

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 125; no. 1; pp. 79 - 84
• Main Authors: Vaquero, Elena, Lazzarin, Natalia, Caserta, Donatella, Valensise, Herbert, Baldi, Marina, Moscarini, Massimo, Arduini, Domenico
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01-03-2006; Elsevier
• Subjects: Adult; Animals; Antibodies, Antiphospholipid - blood; Biological and medical sciences; Embryo Implantation; Embryo, Mammalian - drug effects; Female; Fertilization in Vitro; Gynecology. Andrology. Obstetrics; Hematologic and hematopoietic diseases; Humans; Killer Cells, Natural - cytology; Lymphocyte Count; MEA-f; Medical sciences; Mice; NK cells; Platelet diseases and coagulopathies; Recurrent IVF failure; Thrombophilia; Thrombophilia - complications; Thrombophilia - diagnosis; Thyroid abnormalities; Thyroid Diseases - complications; Thyroid Diseases - diagnosis; Thyroid Gland - immunology; Treatment Failure; Thrombophilia; NK cells; Thyroid abnormalities; Recurrent IVF failure; MEA-f; Human; Hypercoagulability; Relapse; Endocrine gland; Gynecology; Assisted procreation; Hemopathy; Thyroid gland; Obstetrics; Natural killer cell; In vitro fertilization embryo transfer; Adult; Female; Diagnosis; Woman; Coagulopathy
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2005.08.001

The aim of the study was to propose a set of tests to clarify the diagnosis of repeated implantation failure in patients undergoing in vitro fertilization (IVF).
Fifty-nine patients with at least two unsuccessful IVF attempts were included in the study. Blood samples were evaluated for the presence of underlying thyroid abnormalities, antiphospholipid antibodies (aPL), increased levels of natural killer cells (NK), inherited thrombophilia and mouse embryo assay factor (MEA-f). The same tests were performed on 20 normal fertile control patients.
Seventy-six percent of IVF patients showed at least one abnormal result. This incidence was higher with respect to that found among control patients (45%). The prevalence of thyroid abnormalities, aPL and increased NK level was higher in IVF patients whereas no differences were observed in terms of prevalence of inherited thrombophilias and MEA-f.
A better understanding of reproductive failure mechanisms should allow an effective diagnostic flow chart and a focused therapeutic option for patients experiencing repeated IVF failure. With this objective in mind, our data provide two important results: thyroid abnormalities, aPL and increased NK levels are more prevalent in women experiencing IVF failure. No evidence was found for an association between inherited thrombophilia and MEA-f and failure to achieve pregnancy after IVF.