Prevalence and Correlation of Autoantibodies in Women with Infertility: A Cross-Sectional Study

Background & Objective: Infertility is a complex problem affecting a wide variety of couples worldwide. While different factors contribute to infertility, immune disorders have emerged as a key player in the reproductive fitness of male and female. Autoimmune responses concentrated on reproductive tissues, including ovaries, endometrium, and sperm, can impair fertility and result in recurrent pregnancy loss. The present study was conducted with aim to investigate the prevalence and correlation of various autoimmune markers, such as Anti-Sperm Antibodies (ASA), Anti-Phospholipid Antibodies (aPL), Anti-Endometrial Antibodies, and thyroid autoantibodies, in infertile females. Materials & Methods: This cross-sectional study was conducted on 500 women, including 300 fertile control participants and 200 healthy fertile women at Tikrit Teaching Hospital in Iraq. Blood sample was collected to assess the presence of specific antibodies by Enzyme-Linked Immunosorbent Assay (ELISA). Additionally, thyroid function testing was performed to assess the effect of thyroid dysfunction on reproductive outcomes. Data was analyzed using IBM SPSS Statistics version 22 (IBM Corp., Armonk, NY, USA). P<0.05 was considered statistically significant. Results: The findings indicate that autoimmune markers are significantly more prevalent in infertile women compared to healthy controls. Moreover, 30% of the infertile group and 8% of the control group tested positive for Anti-Sperm Antibodies (ASA) (P<0.05). The test is 70% sensitive and 92% specific. Infertile women were 20% more likely to have anti-Phospholipid antibodies (aPL) than controls, who made up 5% of the population (P<0.05). Moreover, 15% of the infertile group and 2% of the control group showed anti-endometrial antibodies (P<0.05). Women who were unable to conceive exhibited significantly elevated levels of thyroid autoantibodies, specifically Anti-TPO (22% vs. 6%) and Anti-Tg (16% vs. 4%) (P<0.05). The intricate interplay of immunological pathways leading to infertility was further substantiated by moderate to high correlations identified between ASA and other autoantibodies, including aCL (r=0.60), Anti-Endometrial Antibodies (r=0.65), Anti-TPO (r=0.50), and Anti-Tg (r=0.55). The findings indicate that autoimmune reactions are substantially correlated with unfavorable reproductive outcomes. Conclusion: The immune system has a significant role in female infertility. Infertility is frequently associated with increased levels of ASA, aPL, anti-endometrial antibodies, and thyroid autoantibodies. This is particularly applicable to women experiencing infertility without a definitive etiology. Interactions among immunological factors may worsen reproductive failure, as evidenced by the established correlations between different autoantibodies. Early diagnosis and targeted treatment of autoimmune illnesses in women experiencing infertility could enhance reproductive success and reduce instances of unexplained infertility in the region.