Study On The Correlation Between Antinuclear Antibody And Assisted Reproductive Outcome

ObjectiveThe purpose of this study is to explore the effect of serum antinuclear antibody(ANA)on the outcome of assisted reproductive pregnancy,understand the diagnostic value of ANA in infertility and assisted reproductive failure,and provide theoretical basis for clinical promotion of eugenics and guidance of infertility treatment.MethodsThe clinical data of the subjects were retrieved from the outpatient electronic medical record and test system through clinical retrospective study.Infertility patients who received in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)assisted pregnancy at the Reproductive Medical Center of Shenyang Women and Children’s Hospital from January 2018 to June 2022 were selected into the study group,and healthy women who were previously naturally pregnant and had no history of spontaneous abortion in the past two years were selected into the control group.The positive rate of ANA was compared between the two groups.According to the ANA test results,the study group was further divided into ANA positive group and ANA negative group.The subjects’ age,body mass index(BMI),infertility years,basic estradiol(b E2),basic follicle stimulating hormone(b FSH),and basic luteinizing hormone(b LH)were collected;Ovulation promotion program,endometrial thickness on HCG day,number of sinus follicles,number of oocytes obtained,number of MII oocytes,number of available embryos,number of high-quality embryos,number of transferred embryos,number of transfer cycles,and type of transferred embryos;The number of gestational sacs,pregnancy cycles and early abortion cycles.SPSS26.0 and Graphpad Prism 8.0 statistical software were used for data analysis and processing,and charts were drawn.The quantitative data were expressed as mean ± standard deviation((?)±s),and the inter-group comparison was performed by t-test;Qualitative data were expressed in percentage(%),X2 test or Fisher’s exact test was used for comparison between groups.α=0.05 is the test standard,and P<0.05 indicates that the difference is statistically significant.Results(1)According to the inclusion and exclusion criteria,313 females in the study group and 172 females in the control group were screened.The study group included67 ANA-positive patients and 246 ANA-negative patients.(2)Comparison of ANA positive rate and population characteristics between the study group and the control group: the ANA positive rate of patients in the study group was significantly higher than that in the healthy control group(21.41% and 8.14%,P=0.0001).There was no significant difference in age,BMI,b E2,b FSH and b LH between the two groups(P>0.05).(3)Comparison of general data between ANA positive group and negative group:there was no statistically significant difference between the two groups in terms of age,BMI,endometrial thickness on HCG day,infertility years,b E2,b FSH and b LH(P>0.05).(4)Comparison of laboratory indicators and pregnancy outcomes between ANA positive group and negative group: there was no significant difference between the two groups in the number of sinus follicles,number of oocytes obtained,number of gestational sacs,number of pregnancy cycles and number of early abortion cycles(P>0.05).The number of MII oocytes,available embryos,high-quality embryos,transferred embryos and transfer cycles in ANA positive group were significantly lower than those in ANA negative group(P<0.05).Compared with ANA negative group,the implantation rate and pregnancy rate of patients in the positive group decreased(17.65% and 27.51%,P=0.001;24.68% and 38.66%,P=0.002),while the abortion rate increased(35.90% and 19.14%,P=0.024).(5)Other related factors that may affect the pregnancy outcome: there was no statistically significant difference in pregnancy rate and early abortion rate between different ovulation promotion programs(Gn RH-ant,Gn RH-a and natural cycle)and different embryo transfer types(fresh embryos transfer and frozen-thawed embryos transfer)(P>0.05).ConclusionANA positive is a risk factor leading to IVF/ICSI-ET treatment failure.Considering that it may affect the quality of oocytes and the development of embryos,thereby reducing the embryo implantation rate and clinical pregnancy rate,and increasing the risk of early abortion.In the future,it is still necessary to further study and explore its relevant mechanisms.It is of great value to regulate the immune function of ANA-positive patients through clinical treatment and improve the success rate of assisted reproduction.