Outcomes of first assisted reproductive technology treatment in infertile women with and without antinuclear antibodies: A prospective cohort study

Background: It has been shown that antinuclear antibodies (ANAs) are associated with adverse reproductive events. The presence of ANAs may reduce the pregnancy rate in women undergoing assisted reproductive technology (ART) treatment. Methods: This study aimed to investigate the potential effect of ANAs on the outcomes of infertile women undergoing in-vitro fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI) for the first time. In total, 907 women were enrolled, with 192 (21.14 %) cases in the ANA+ group and 715 (78.86 %) cases in the ANA- group. Baseline data were collected, and associations between ANAs and oocyte maturation rate, high-quality embryo rate, clinical pregnancy rate, live birth rate and miscarriage rate were analysed. Results: Compared with the ANA- group, the ANA+ group had a considerably lower oocyte maturation rate (0.69 +/- 0.31 vs 0.77 +/- 0.26; P = 0.003) and a lower high-quality embryo rate (0.53 +/- 0.30 vs 0.78 +/- 0.92; P < 0.01). ANAs had no effect on clinical pregnancy rate, live birth rate and miscarriage rate in infertile women receiving ART for the first time. Conclusions: These findings suggest that ANAs reduce oocyte maturation rate and high-quality embryo rate in infertile women undergoing IVF-ET/ICSI for the first time, but do not have a significant effect on clinical pregnancy rate, live birth rate and miscarriage rate. When testing for ANAs is part of the planned treatment protocol, this should be undertaken in advance of starting IVF-ET/ICSI.