Background: Anti -ovarian auto -antibodies play an important role in both endocrine and reproductive functions of the human ovary and can influence these functions negatively. Auto antibodies to zona- pellucida (AZA) also seem to be important autoantibodies implicated in reproduction. There are some debates on the relation of AZA with infertility, repeated IVF attempts, and outcome of in vitro fertilization. In this study we assessed the presence of AZA in the follicular fluid (FF) of women who underwent in-vitro fertilization (IVF) and embryo transfer in relation to etiology of infertility and multiple puncture of ovaries.
Materials and Methods: In this prospective study, follicular fluids from 96 infertile women, (19-40 years old, 31.5±5.1), who were candidates for intracytoplasmic sperm injection (ICSI), were evaluated. According to the etiology of infertility, 80 women had explained infertility whereas 16 had unexplained infertility. All FFs were evaluated for presence of AZA by ELIZA test.
Results: Twenty of samples (20.8%) were positive for AZA. In patients with unexplained infertility, AZA antibody in follicular fluid, was significantly higher than the group with proven etiology of infertility (P value=0.001). Also 20.4% of patients who had been punctured previously, showed AZA in their FF which is statistically similar to patients who were punctured for the first time. (P value)
Conclusions: The high incidence of AZA in infertile women, especially women with unexplained infertility has to be considerd.Relation of the presence AZA and repeated puncture of ovaries is still debatable. Determinations of AZA are highly recommended in evaluation of infertile couples especially in patient with unexplained infertility.