Bovine serum albumin immunization: a new risk of allergy during protocols for in vitro fertilization.

Three patients having undergone protocols for in vitro fertilization (IVF) showed an allergic reaction suggesting seric disease 6 to 10 days after follicle aspiration. The responsibility of bovine serum albumin, present in the follicle-rinsing fluid and in the medium used for embryo culture was suspected. An immunological study was carried out, using two groups for comparison. Group 1: 7 controls. Group 2: 11 women having undergone IVF protocols without incident. Anti-BSA antibodies were present in low quantities in one or two subclasses of IgG and IgA in Group 1, and in several subclasses at higher levels in nine of 11 subjects from Group 2. The IgG4 response predominated 7 times out of 9. The antibody content gradually fell after the IVF attempt. An immune response predominated in the IgG1 in two patients. Skin test for the two fluids and BSA were positive only in the three patients. These results show the frequency of immunization to BSA induced through the ovarian and peritoneal pathways. Seric disease corresponds to a rise in IgG1. The association of a IgE-dependent sensitization is suspected. The authors suggest the possibility of an interference of these immune processes with implantation and propose the elimination of heterologous proteins from fluids. They also suggest that LH-RH analogues facilitate immune responses.