ABSTRACT
Accumulating evidence suggests that the fetal-placental semi allograft is afforded protection by local immunomodulating factors and that immunologic recurrent abortion may result from an imbalance or breakdown in the mechanisms responsible for immune homeostasis.1-4 The most compelling association between pregnancy loss and autoimmune phenomena has been with the presence of antiphospholipid antibodieslupus anticoagulant and anticardiolipin antibody. These auto antibodies are also strongly associated with both venous and arterial thrombosis and thrombocytopenia.5 Thrombosis occurs in 25 to 33 percent of people with the lupus coagulant6 and in over 75 percent of patients with elevated anticardiolipin antibodies.7 Antiphospholipid antibodies (APA) are a group of organ non-specific auto antibodies that bind to negatively charged phospholipids. Their presence has been associated with reproductive failure; the most consistently reported phenomenon is the association between recurrent spontaneous abortion and the presence of immunoglobulin (IgG) anticardiolipin and lupus anticoagulant (LAC).8-10 At present, there is convincing evidence that abnormal autoimmune function is an etiological factor in approximately 10 percent of patients with recurrent pregnancy loss11-13 and assessment of Antiphospholipid antibodies, namely the Lupus anticoagulant (LA) and Anticardiolipin antibodies (aCL), has become routine in the evaluation of women having recurrent abortion.13-16 A particular subpopulation of anticardiolipin antibodies may be strongly represented in the male partners, the clinical significance of which remains to be established.17
