【摘要】 目的探讨抗滋养细胞膜抗体(ATA)、抗子宫内膜抗体(EmAb)、抗HCG抗体对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法选择2002年1月~2007年7月在本生殖医学中心由于不明原因性不育、女方输卵管因素和(或)男方轻度少弱精子症因素不育而接受IVF-ET治疗的妇女140例,其中多次种植失败31例,生化妊娠丢失26例及临床妊娠丢失18例,持续妊娠65例(对照组)。比较各组和对照组妇女各种不育因素所占比例,同时比较各组妇女血清ATA、EmAb和抗HCG抗体阳性率。结果多次种植失败组、生化妊娠丢失组及临床妊娠丢失组不明原因性不育明显高于对照组(χ2=8.2~14.6,P<0.01);多次种植失败组、生化妊娠丢失组及临床妊娠丢失组ATA阳性率显著高于对照组(χ2=6.8~11.8,P<0.01);生化妊娠丢失组和临床妊娠丢失组抗HCG抗体高于对照组(χ2=4.4、5.3,P<0.05);多次种植失败组妇女血清EmAb阳性率明显高于其他组(χ2=5.5,P<0.05)。结论免疫性因素是不明原因性不孕的重要原因;过度表达的ATA可干扰整个妊娠过程,抗HCG抗体的存在能增加IVF-ET临床妊娠流产率和生化妊娠流产率;EmAb可干扰胚胎种植,导致IVF-ET反复种植失败。更多还原

【Abstract】 Objective To assess the effect of antitrophoblast antibody,EmAb and HCG-Ab on in vitro fertilization and embryo transfer(IVF-ET) outcome. Methods This study included 140 infertility women of unexplained reasons,salpingemphraxis and/or male factor undergoing IVF-ET,of whom,31 with repeated failure of implantation;26 with biochemical loss of pregnancy;18 with clinical pregnancy loss.Sixty-five with clinical pregnancy served as control group.The ratio of different reasons of infertility and the rate of antitrophoblast antibody(ATA),EmAb and HCG-Ab in different groups were compared. ResultsThe rate of immune infertility was higher in repeated implantation failure group,biochemical pregnancy group,and clinical pregnancy loss group than in control group(χ2=8.2-14.6,P<0.01),the ATA positive rate in those three groups was also higher than that of the control group(χ2=6.8-11.8,P<0.01).The serum EmAb in the repeated implantation group was higher than the other groups(χ2=5.5,P<0.05). Conclusion Immune factor is an important cause of unexplained infertility;overexpress of ATA may interfere the whole course of pregnancy.EmAb can interfere embryo implanting and HCG-Ab is one of the reasons of decreasing IVF-ET pregnancy.更多还原