Ovarian antibody testing (AOA) is controversial but new research is establishing a place for the AOA test prior to IVF to identify women at risk of IVF failure. Studies have shown that identifying such women can open up the possibility of corticosteroid treatment which suppresses antibody production before and during the IVF, proven to improve IVF success.
The AOA test establishes whether or not a woman has an autoimmune malfunction which has resulted in anti-ovarian antibodies attacking the ovaries in a similar fashion to the way in which the body attacks the joints in rheumatoid arthritis. An astute clinician may suspect ovarian antibodies if a woman has a history of poor IVF response, very low estradiol levels, and other auto immune factors but sometimes there are no hidden clues.
Infertility clinics vary greatly in the range tests that they offer women before commencing and IVF cycle. Some clinics offer very thorough tests and assess autoimmune factors before IVF while others seldom test immune factors - which may cause IVF failure and miscarriage - unless the patient has experienced 2-3 miscarriages.
This lack of testing can have very unfortunate consequences; some women experience multiple failed IVF cycles before discovering that auto-immune factors such as AOA may have been to blame. Had these factors been discovered - and treated - sooner maybe a different outcome may have been possible.
A 2010 study sought to establish whether AOA testing should have a higher profile in the batch of test offered to infertile women before IVF. Two groups of women undergoing IVF-ET were studied; group 1 were AOA positive who received corticosteroid therapy known to reduce antibody levels and enhance the outcome of IVF for such women. Group 2 did not have evidence of ovarian antibodies. A total of 570 infertile women were studied.
The researchers of the study concluded that:
"AOA testing could be included in the battery of tests investigating and treating infertility."
"Infertile women seeking assisted reproduction should have their serum tested for anti-ovarian antibodies prior to initiation of hormonal stimulation protocols. This would not only ensure efficacy of the IVF-ET but also save on the huge time and money invested on this protocol."
Even when AOA levels become undetectable subsequent to corticosteroid treatment, some women with a history of ovarian antibodies will still have a tendency to poor IVF response and a smaller number of oocytes at pick-up. Other women though will have their chances of succeeding significantly upped through AOA testing and the opportunity to pursue corticosteroid treatment. If you are about to pursue IVF this little piece of information may prove to be invaluable.
Can anti-ovarian antibody testing be useful in an IVF-ET clinic. Journal of Assisted Reproduction and Genetics. Eusebio S Pires, et al. Vol 28, number 1, 55-64, DOI:10.1007/s10815-010-9488-2