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Obstetrics & Gynecology:
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Evidence of Gonadal and Gonadotropin Antibodies in Women With a Suboptimal Ovarian Response to Exogenous Gonadotropin.

MEYER, WILLIAM R. MD; LAVY, GAD MD; DeCHERNEY, ALAN H. MD; VISINTIN, IRENE; ECONOMY, KATHY; LUBORSKY, JUDITH L. PhD

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Abstract

Failure to respond to human menopausal gonadotropin (hMG) with adequate ovarian stimulation is associated with a poor prognosis in subsequent cycles in women participating in an in vitro fertilization/embryo transfer program. Sera from 26 menstruating women (mean age 38 +/- 4.3 years) identified as "low responders" with either tubal or male factor infertility, mean baseline FSH values of 11 mlU/mL, and peak serum estradiol levels lower than 300 pg/mL were assessed for specific antibodies to human ovary and gonadotropins. Twenty-five infertile women with tubal or male factor infertility with a good response to hMG served as controls. Ninety-two percent of low responders had antibodies to FSH and 65% had antibodies to LH when assessed by enzyme-linked immunosorbent assay. Similarly, 77% of low responders had ovarian antibodies. No hepatic antibodies were found in the sera of low responders, indicating that the positivity was not a general interaction with cell components. None of the "good responders" had antibodies to gonadotropins or to ovarian or liver tissue. The significant differences in antibodies between the groups supports a possible immunologic cause for low ovarian stimulation response to gonadotropin

(C) 1990 The American College of Obstetricians and Gynecologists

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