Review Article

Review on Autoimmune Reactions in Female Infertility: Antibodies to Follicle Stimulating Hormone

Table 2

Serum autoantibodies in female infertility and infertility-related diseases.

Patients (N)AutoantibodiesMethodsStudy designAuthors (reference no.)

POF

POF (45)AOA 47%*
Antioocyte Aab 47%*
AOA or anti-oocyte Aab 69%*
Anti-LH 6.7% (also AOA positive)
AThA 18%*
Antiplacental Aab 22%*
ELISACCLuborsky et al. 1990 [30]

POF (45)AOA 24–60%*ELISACCWheatcroft et al. 1994 [68]

POF (48)Anti-3 beta hydroxysteroid dehydrogenase Aab 21%*IB, IF, cDNA screeningCCArif et al. 1996 [69]

POF (46)AOA IgG, IgA or IgM 59%—IgG 74.1%, IgA 33.3%, IgM 29.6%*ELISACCFénichel et al. 1997 [29]

(A) POF (14)
(B) IVF poor responders (29)
(C) IVF good responders (14)
FSH blocking IgG:
 (A) 21.4%
 (B) 6.9%
 (C) 85%*
IgG purification, cell culture exposureCCReznik et al. 1998 [70]

POF (30)
Unexplained infertility (38)
AOA and AThA 60%*
ANA and ACA 16%*
AOA 53%*
AThA 30%*
EIACCLuborsky et al. 1999 [32]

POS positive for AOA (36)Anti-FSH (anti-V14D) 94.4%*ELISA, IB, IF, peptide screeningPGobert et al. 2001 [71]

POF (15)AOA 66.6%*
Antizona pellucida Aab 53.3%*
TMA 33.3%
IHCCCKelkar et al. 2005 [31]

IVF patients

IVF poor responders with male infertility or TFI (26)AOA 77%*
Anti-FSH 92%*
Anti-LH 65%*
ELISACCMeyer et al. 1990 [72]

IVF failure (80)AOA 12.5%*IFCCGeva et al. 1999 [62]

IVF failure (17)1 out of 6 common Aab IgG 82.3%*:
 ACA 58.8%
 LA 47.1%
 AThA 58.8%
 ANA 58.8%
 SMA 11.8%
ELISA, IF, PDCACCPutowski et al. 2004 [61]

IVF patients (135):
 (A) PCOS, endometriosis, unexplained infertility
 (B) TFI or male infertility
(A) and (B) higher titer of anti-FSH IgG, IgA and IgM* (A) 1 out of 7 common Aab IgG 49%*-ANA 2 preparations, SMA, PCA, ACA, B2-GPI or anti-TPOELISA, IFCCHaller et al. 2007 [73]

IVF poor responders (16)Anti-FSH IgA 37.5%*
Anti-FSH IgG 31.3%*
ELISACCHaller et al. 2008 [74]

TFI with IVF failure (156)AEA IgA* (antialpha enolase)IB, MSCCSarapik et al. 2010 [43]

TFI (21)Antichlamydial HSP60 antibody titer*ELISA, IB, IFCCRodgers et al. 2010 [42]

Non-IVF infertility patients

(A) Unexplained infertility (26)
(B) Unexplained abortion (24)
2 APA, 5 antihistone or 4 antipolynucleotide IgG, IgA or IgM (A 88% and B 70.8%)ELISAPGleicher et al. 1989 [66]

Pregnancy complications (69):
 (A) Early pregnancy loss
 (B) Foetal death
 (C) Preeclampsia
AThA 37.7%*:
 (A) 37.9%*
 (B) 40.9%*
 (C) 33.3%*
ELISA, PDCA, RIACCMecacci et al. 2000 [11]
Infertility (108):
 Menstrual cycle disturbances
 Anovulation
 Luteal phase deficiency
 Unexplained infertility
 PCOS
 Endometriosis
1 out of 9 common Aab IgG 40.7%*
 ANA 13.9%*
 SMA 27.8%*
 TMA 1.9%*
 PCA 0.6%
 B2-GPI 4.4%
 ACA 5%
ELISA, IFCPReimand et al. 2001 [25]

Infertility (438):
 Endometriosis
 TFI
 Ovarian dysfunction
 Male infertility
 Unexplained infertility
Anti-TPO 14%:
 18% in female infertility*
 29% in endometriosis*
RIACCPoppe and Velkeniers 2002 [60]

(A) Infertility (178)—PCOS, endometriosis
(B) Uncomplicated pregnancy (75)
(A) higher titer of anti-FSH (anti-V14D) IgA*
(B) lower titer of anti-FSH (anti-V14D) IgG, IgM*
ELISACCHaller et al. 2005 [75]

Infertility-related diseases

Endometriosis (13)AOA, AEA, anti-theca cell Aab, anti-granulosa cell Aab titers*IF, PHACCMathur et al. 1982 [50]

Endometriosis (59)ANA 28.8%, LA 45.5% (inversely related to disease stage)
1 out of 16 antigens IgG 64.5%
1 out of 16 antigens IgM 45.2%
IF, PDCAPGleicher et al. 1987 [21]

Endometriosis (60)Anti-α 2HS glycoprotein and antitransferrin titers*ELISACCMathur et al. 1999 [49]

PCOS (34)AOA IgG, IgA or IgM 44%—IgG 27%, IgA 3%, IgM 27%*ELISACCFénichel et al. 1999 [19]

*Statistically significant compared to the reference ( ), Aab-autoantibodies, ACA-anticardiolipin autoantibodies, AEA-antiendometrial autoantibodies, ANA-antinuclear autoantibodies, AOA-antiovary autoantibodies, APA-antiphospholipid autoantibodies, AThA-anti-thyroid autoantibodies, B2-GPI-anti-beta 2-glycoprotein I autoantibodies, EIA-enzyme immunoassay, ELISA-enzyme-linked immunosorbent assay, FSH-follicle stimulating hormone, HSP-heat shock protein, IF-immunofluorescence, IB-immunoblot analysis, IHC-immunohistochemistry, IVF in vitro fertilization, LA-lupus anticoagulant, CC-case-control study, CP-cases-population study, LH-luteinizing hormone, MS-mass spectrometry, P-prevalence, PCA-parietal cell autoantibodies, PCOS-polycystic ovary syndrome, PDCA-phospholipid-dependent clotting assay, PHA-passive haemagglutination, POF-premature ovarian failure, RIA-radioimmune assay, SMA-smooth muscle autoantibodies, TFI-tubal factor infertility, TMA-thyroid microsomal autoantibodies, TPO-thyroid peroxidase, V14D-78-93 amino acid immunodominant epitope on FSH.