Serum autoantibodies and assisted reproduction: A systematic review.

INTRODUCTION

The impact of isolated autoantibody positivity in women without diagnosed autoimmune disease on assisted reproductive technology (ART) outcomes remains controversial. This systematic review evaluated the association between antithyroid antibodies (ATA), antiphospholipid antibodies (APL), and antinuclear antibodies (ANA) and ART outcomes.

METHODS

PubMed, Embase, and the Cochrane Library were searched for observational studies published between 2006 and 2024 evaluating the association between isolated autoantibody positivity and ART outcomes.

RESULTS

Thirty-seven studies investigated ATA, nine APL, and eight ANA. Overall, ATA positivity did not appear to adversely affect ART outcomes, including cumulative live birth rate and live birth rate, although some studies reported increased miscarriage rates. Limited evidence suggested that APL positivity may be associated with increased miscarriage risk, whereas ANA positivity appeared to be associated with lower clinical pregnancy rates and higher miscarriage rates.

CONCLUSION

Current evidence suggests that isolated ATA positivity is unlikely to substantially impair ART outcomes, while APL and ANA positivity may negatively affect selected reproductive outcomes. These findings may help guide interpretation of isolated autoantibody positivity during infertility evaluation and ART counseling. However, the available evidence remains heterogeneous, and further well-designed studies are needed.