Roles of Antiphospholipid Antibodies, Antithyroid Antibodies and Antisperm Antibodies in Female Reproductive Health

Autoantibodies are implicated in various human diseases. In this review, the effects of three different types of autoantibodies (antiphospholipid antibody, antithyroid antibody, and antisperm antibody) on female reproductive health are critically examined. Antiphospholipid antibodies are being detected more frequently in women undergoing in vitro fertilization, but their presence does not appear to influence the outcome of pregnancy, miscarriage, or live birth rates. Available evidence makes it conclusive that antiphospholipid antibodies play negligible roles in recurrent miscarriage. Treatment with aspirin together with low-molecular-weight heparin appears to be effective for recurrent miscarriage. Although antithyroid antibodies are commonly found in women of reproductive age, implantation rates and miscarriage rates are unaffected when women have normal thyroid function. Women with thyroid dysfunction should be treated with <smlcap>L</smlcap>-thyroxine before conception or at early gestational stages to avoid pregnancy complications. Antisperm antibodies are uncommon but are most often associated with ovarian hypofunction. They are believed to cause fertilization failure when found at high titers in seminal plasma, or in the mucosal immune system of women. Intrauterine artificial insemination and in vitro fertilization/embryo transfer are effective treatment modalities for antisperm antibody-related infertility, although this remains a controversial topic in the field of female infertility.