辅助生殖技术中的抗核抗体:临床相关性和治疗启示
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南京医科大学附属妇产医院(南京市妇幼保健院)生殖医学中心,江苏 南京 210004

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国家自然科学基金(82371670)


Antinuclear antibodies in assisted reproductive technology:clinical relevance and therapeutic implications
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Affiliation:

Center of Reproductive Medicine,Women’s Hospital of Nanjing Medical University,Nanjing Women and Children’s Healthcare Hospital,Nanjing 210004 ,China

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    摘要:

    在辅助生殖技术(assisted reproductive technology,ART)的应用中,抗核抗体(antinuclear antibody,ANA)对不孕症患者妊娠结果的影响受到关注。ANA作为自身免疫异常的生物标志物,与不明原因不孕症的关联性及其对卵母细胞和胚胎质量的潜在影响已被广泛研究。现有证据表明,ANA阳性可能与卵巢储备功能降低、胚胎发育不良、临床妊娠率下降和流产风险增加相关。卵泡液中的ANA水平被认为是预测自体免疫相关性不孕的敏感指标。特定的ANA亚类,如抗双链DNA抗体和抗着丝点抗体,与卵母细胞成熟障碍和胚胎发育迟缓有关。尽管如此,ANA阳性与女性生育能力下降及不良生殖结果之间的直接联系仍需进一步研究以明确。文章还讨论了针对ANA阳性患者的不同治疗方案,包括糖皮质激素、低剂量阿司匹林和羟氯喹等,旨在为ART的临床实践和研究提供指导。

    Abstract:

    In the application of assisted reproductive technology(ART),the impact of antinuclear antibody(ANA)on the pregnancy outcomes of infertile patients has garnered attention. ANA,as a biomarker of autoimmune abnormalities,has been extensively studied for its association with unexplained infertility and its potential effects on oocyte and embryo quality. Current evidence suggests that a positive ANA status may be associated with reduced ovarian reserve function,poor embryo development,decreased clinical pregnancy rates,and increased risk of miscarriage. The level of ANA in follicular fluid is considered a sensitive indicator for predicting autoimmunity-related infertility. Specific ANA subtypes,such as anti -dsDNA antibodies and anti -centromere antibodies(ACA),are related to oocyte maturation disorder and delayed embryo development. Nevertheless,the direct link between a positive ANA status and the decline in female fertility and adverse reproductive outcomes requires further research for clarification. The review also discusses various treatment options for ANA-positive patients,including glucocorticoids,low-dose aspirin,and hydroxychloroquine, aiming to provide guidance for clinical practice and research in ART.

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丁凯,李欣,赵纯.辅助生殖技术中的抗核抗体:临床相关性和治疗启示[J].南京医科大学学报(自然科学版),2025,(3):301-310

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  • 收稿日期:2024-12-12
  • 在线发布日期: 2025-03-17
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