Six kinds of anti-phospholipid antibodies (aPLs) in ovulatory mucus and seminal plasma from couples with repeated miscarriages.

Objective-Determination of aPLs in ovulatory mucus and in seminal plasma in 18 infertile couples (women, median age 33.2, range 28-39 years; men, median age 36.4, range 29-46 years) with repeated unexplained miscarriages (four to nine spontaneous abortions). Women with high levels of aPLs in sera were excluded from the study. Methods-aPL screening included cardiolipin (Sevac Prague), L-alpha-phosphatidic acid, L-alpha-phosphatidylethanolamine, L-alpha-phosphatidyl-DL-glycerol, £-alpha-phosphatidylinositol, and L-alpha-phosphatidyl/serine (Sigma, USA). These were determined in isotypes IgG and IgA by an ELISA method. Statistical analysis of aPL results was made by cut-off levels of aPLs for both Ig isotypes by using 3 SD or 95th percentile calculated by STATGRAPHICS. Control group was created from four fertile healthy couples. Results-Levels of aPLs in ovulatory cervical mucus were in the majority very low, except for IgA-aPLs-inositol. Very high interindividual differences in aPLs were found in seminal plasma. IgA-aPL-ethanolamine and -DL-glycerol, and IgG-aPL-L-serine and -DL-glycerol predominated in seminal plasma. Extremely high IgA levels of aPLs in all above-mentioned antigens, except cardiolipin, were found in one man of an infertile couple. Conclusion-The passage of abnormal aPLs levels from seminal plasma into the site of conception during often repeated, unprotected intercourses is supported by the findings.