Anti - zona pellucida antibodies in infertile patients in relation to multiple puncture of ovaries and unexplained infertility

Auto antibodies to zona-pellucida (AZA) seem to be important autoantibodiesimplicated in reproduction, with substantial role in both endocrine and reproductive functions of thehuman ovary. There are some debates on the relation of AZA with infertility, repeated In VitroFertilization (IVF) attempts, and outcome of it.

In this study, we assessed the presence of AZA in the follicular fluids (FFs) of womenwho underwent intra cytoplasmic sperm injection (ICSI), in relation to etiology of infertility andmultiple puncture of ovaries.

In this prospective study, follicular fluids were evaluated from 96 infertilewomen, (19-40 years old, 31.5±5.1), who were candidates for ICSI based on the etiology ofinfertility. From these 80 women had explained infertility whereas 16 had unexplained infertility.All FFs were evaluated for presence of AZA by ELISA test.

Twenty patients (20.8%) were positive for AZA in follicular fluid. In patients withunexplained infertility, AZA antibody in follicular fluid, was significantly higher than the groupwith proven etiology of infertility (p=0.001). In addition, 20.4 % of patients who had beenpunctured previously showed AZA in their FFs which is statistically similar to the patients whowere punctured for the first time.

The high incidence of AZA in infertile women, especially women with unexplainedinfertility has to be considered. Relation of the presence AZA and repeated puncture of ovaries isstill debatable. Determinations of AZA are highly recommended in evaluation of infertile couplesespecially in patient with unexplained infertility.