Background/Aim Unexplained infertility constitutes around 15% of patients presenting with infertility. It is claimed today that unexplained infertility is often associated to immunologic factors. This condition may be a result of autoimmunity (in man and woman) or of isoimmunity (in woman). Antisperm antibodies (ASA) are detected in 7 to 15 % of men and in 13 to 80 % in women with unexplained infertility. There is some evidence suggests that anti-thyroid antibodies (ATA) could exert a negative influence on the female reproductive potential. The aim of this study was to determine the immunologic aspect in idiopathic infertility by detecting Non-organ specific anticardiolipin (aCL), antisperm antibodies (ASA) and antithyroglobulin (TgAt) antibodies in patients with unexplained infertility. Methods: This study was carried out on 55 women aged from 27 to 42 years. The cases were collected from January 2011 to June of the same year. The cases were admitted to the infertility outpatient clinic of the Gynecological and Obstetric Department of Benha University Hospital. Investigations were performed in Microbiology and Immunology Department of Benha Faculty of Medicine. Women under study were classified into two groups: Group I: included 30 infertile women. Group II (control): included 25 fertile women, women of this group were selected to have two children at least and they were selected from women who come to the clinic to insert IUD. Patients and controls were subjected to: Indirect immunofluorescence assay (IFA) that was used for detection of circulating TgAt. Serum level of aCL was detected by enzyme-linked immunosorbant assay (ELISA), while ASA level in serum and cervical secretion was also measured by enzyme-linked immunosorbant assay (ELISA). Results: Serum ASA were positive in sera of (33.3%) of infertile women, while it was positive in (5%) in cervical secretion. Postcoital test was negative in (36.7%) of infertile women and in all women with positive ASA in cervical secretion. In fertile women aCL was below negative cut-off level (96%), while women with unexplained infertility were positive in (17%) for IgG antibodies & (36.7%) for IgM and (16.7%) for both together. ATA were detected in (20%) of infertile women and (12%) of fertile controls.
In conclusion: altered immune system function & autoimmunity is a possible explanation for some cases of unexplained infertility as demonstrated by increased level of both organ specific and non-organ specific autoantibodies in women with unexplained infertility.
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