Association of antibodies against gonadotropins and female sex hormones with reproductive disorders

Menzhinskaya I.V., Vanko L.V.

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow 117997, Ac. Oparina str. 4, Russia
Objective. To analyze the data of current research literature on the role of antibodies against gonadotropins and female sex hormones in reproductive disorders in women.
Material and methods. The review includes data of foreign and national articles on the research topic found in Pubmed and eLIBRARY and published in the last 20 years.
Results. According to scientific publications the production of antibodies against gonadotropins is induced by the use of hormonal drugs or contraceptive vaccines, and can also occur spontaneously in women with infertility and recurrent pregnancy loss. The effect of antibodies is associated with their ability to neutralize the biological activity of the hormone. Enzyme-linked immunosorbent assay is most commonly used for the detection of antibodies in blood, and intradermal testing is employed for diagnosis of hypersensitivity to female sex hormones. Antibodies against gonadotropins and female sex hormones are considered as possible risk factors for infertility, IVF failure and pregnancy loss.
Conclusion. Early detection of antibodies or hypersensitivity to the hormones and carrying out appropriate treatment and preventive measures can increase the treatment efficacy of infertility and improve outcomes of pregnancy in women with recurrent abortion.

Keywords

antibodies to gonadotropins and female sex hormones
miscarriage
infertility

References

1. Carp H.J., Selmi C., Shoenfeld Y. The autoimmune bases of infertility and pregnancy loss. J. Autoimmun. 2012; 38(2-3): J266-74.

2. Cervera R., Balasch J. Autoimmunity and recurrent pregnancy losses. Clin. Rev. Allergy Immunol. 2010; 39(3): 148-52.

3. Haller-Kikkatalo K., Salumets A., Uibo R. Review on autoimmune reactions in female infertility: antibodies to follicle stimulating hormone. Clin. Dev. Immunol. 2012; 2012: Article ID 762541.

4. Pennell L.M., Galligan C.L., Fish E.N. Sex affects immunity. J. Autoimmun. 2012; 38(2-3): J282-91.

5. Shoenfeld Y., Zandman-Goddard G., Stojanovich L., Cutolo M., Amital H., Levy Y. et al. The mosaic of autoimmunity: hormonal and environmental factors involved in autoimmune diseases – 2008. Isr. Med. Assoc. J. 2008; 10(1): 8-12.

6. Цырлина Е.В., Порошина Т.Е. Хорионический гонадотропин как маркер трофобластической болезни. Практическая онкология. 2008; 9(3): 150-9. [Tsyirlina E.V., Poroshina T.E. Chorionic gonadotropin as a marker of trophoblastic disease. Prakticheskaya onkologiya. 2008; 9(3): 150-9. (in Russian)]

7. Cole L.A. Hyperglycosylated hCG, a review. Placenta. 2010; 31(8): 653-64.

8. Cocco C., Brancia C., D’Amato F., Noli B. Pituitary gonadotropins and autoimmunity. Mol. Cell. Endocrinol. 2014; 385(1-2): 97-104.

9. Ванян Р.Э., Менжинская И.В., Долгушина Н.В. Роль аутоиммунных антител в развитии «бедного» овариального ответа в программах вспомогательных репродуктивных технологий (обзор литературы). Проблемы репродукции. 2014; 20(3): 53-7. [Vanyan R.E., Menzhinskaya I.V., Dolgushina N.V. The role of autoimmune antibodies in the development of a „poor” ovarian response in programs of assisted reproductive technologies (literature review). Problemy reproduktsii. 2014; 20(3): 53-7. (in Russian)]

10. Yao B., Yi N., Zhou S., OuYang W., Xu H., Ge Y. et al. The effect of induced anti-follicle-stimulating hormone autoantibody on serum hormone level and apoptosis in rat testis. Life Sci. 2012; 91(3-4): 83-8.

11. Meyer W.R., Lavy G., DeCherney A.H., Visintin I., Economy K., Luborsky J.L. Evidence of gonadal and gonadotropin antibodies in women with a suboptimal ovarian response to exogenous gonadotropin. Obstet. Gynecol. 1990;75(5): 795-9.

12. Luborsky J.L., Visintin I., Boyers S., Asari T., Caldwell B., DeCherney A. Ovarian antibodies detected by immobilized antigen immunoassay in patients with premature ovarian failure. J. Clin. Endocrinol. Metab. 1990; 70(1): 69-75.

13. Reznik Y., Benhaïm A., Morello R., Herlicoviez M., Ballet J.J., Mahoudeau J. High frequency of IgG antagonizing follicle-stimulating hormone- stimulated steroidogenesis in infertile women with a good response to exogenous gonadotropins. Fertil. Steril. 1998; 69(1): 46-52.

14. Gobert B., Jolivet-Reynaud C., Dalbon P., Barbarino-Monnier P., Faure G.C., Jolivet M., Béné M.C. An immunoreactive peptide of the FSH involved in autoimmune infertility. Biochem. Biophys. Res. Commun. 2001;289(4): 819-24.

15. Shatavi S.V., Llanes B., Luborsky J.L. Association of unexplained infertility with gonadotropin and ovarian antibodies. Am. J. Reprod. Immunol. 2006; 56(5-6): 286-91.

16. Haller K., Mathieu C., Rull K., Matt K., Bene M.C., Uibo R. IgG, IgA and IgM antibodies against FSH: serological markers of pathogenic autoimmunity or of normal immunoregulation? Am. J. Reprod. Immunol. 2005; 54(5): 262-9.

17. Haller K., Salumets A., Grigorova M., Talja I., Salur L., Béné M.C. et al. Putative predictors of antibodies against follicle-stimulating hormone in female infertility: a study based on in vitro fertilization patients. Am. J. Reprod. Immunol. 2007; 57(3): 193-200.

18. Haller K., Salumets A., Uibo R. Anti-FSH antibodies associate with poor outcome of ovarian stimulation in IVF. Reprod. Biomed. Online. 2008;16(3): 350-5.

19. Tsampalas M., Gridelet V., Berndt S., Foidart J.M., Geenen V., Perrier d’Hauterive S. Human chorionic gonadotropin: a hormone with immunological and angiogenic properties. J. Reprod. Immunol. 2010; 85(1): 93-8.

20. Gleicher N. Autoantibodies in infertility: current opinion. Hum. Reprod. Update. 1998; 4(2): 169-76.

21. Claustrat B., David L., Faure A., Francois R. Development of anti-human chorionic gonadotropin antibodies in patients with hypogonadotropic hypogonadism. A study of four patients. J. Clin. Endocrinol. Metab. 1983; 57(5): 1041-7.

22. Sokol R.Z., McClure R.D., Peterson M., Ronald S., Swerdloff R.S. .Gonadotropin therapy failure secondary to human chorionic gonadotropin-induced antibodies. J. Clin. Endocrinol. Metab. 1981; 52(5): 929-32.

23. Nieschlag E., Bernitz S., Töpert M. Antigenicity of human chorionic gonadotrophin preparations in men. Clin. Endocrinol. (Oxf). 1982; 16(5): 483-8.

24. Braunstein G.D., Bloch S.K., Rasor J.L., Winikoff J. Characterization of antihuman chorionic gonadotropin serum antibody appearing after ovulation induction. J. Clin. Endocrinol. Metab. 1983; 57(6): 1164-72.

25. Talwar G.P. Making of a vaccine preventing pregnancy without impairment of ovulation and derangement of menstrual regularity and bleeding profiles. Contraception. 2013; 87(3): 280-7.

26. Talwar G.P., Singh O.M., Gupta S.K., Hasnain S.E., Pal R., Majumbar S.S. et al. The HSD-hCG vaccine prevents pregnancy in women: feasibility study of a reversible safe contraceptive vaccine. Am. J. Reprod. Immunol. 1997; 37(2): 153-60.

27. Deshmukh U.S., Talwar G.P., Gupta S.K. IgG subclass distribution of anti-hCG and antidiphtheria toxoid antibodies in women immunized with a β-hCG based immunocontraceptive vaccine. J. Reprod. Immunol. 1994; 26(1): 65-72.

28. Pala A., Coghi I., Spampinato G., Di Gregorio R., Strom R., Carenza L. Immunochemical and biological characteristics of a human autoantibody to human chorionic gonadotropin and luteinizing hormone. J. Clin. Endocrinol. Metab. 1988; 67(6): 1317-21.

29. Amato F., Warnes G.M., Kirby C.A., Norman R.J. Infertility caused by hCG autoantibody. J. Clin. Endocrinol. Metab. 2002; 87(3): 993-7.

30. Zou S.H., Yang Z.Z., Zhang P., Song D.P., Li B., Wu R.Y., Cong X. Autoimmune disorders affect the in vitro fertilization outcome in infertile women. Zhonghua Nan Ke Xue. 2008; 14(4): 343-6.

31. Кирющенков П.А., Сухих Г.Т., Ванько Л.В., Пономарева И.В. Клинико-иммунологическое значение аутоантител к хорионическому гонадотропину при невынашивании беременности. Акушерство и гинекология. 1996; 4: 14-6. [Kiryuschenkov P.A., Suhih G.T., Vanko L.V., Ponomareva I.V. Clinical and immunological significance of autoantibodies to chorionic gonadotropin in case of miscarriage. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 1996; (4): 14-6. (in Russian)]

32. Кирющенков П.А. Особенности ведения женщин с аутосенсибилизацией к хорионическому гонадотропину человека. Гинекология. 2003; 5(5): 222-4. [Kiryuschenkov P.A. Features of conducting women with autosensibilization to human chorionic gonadotropin. Ginekologiya. 2003; 5(5): 222-4. (in Russian)]

33. Сидельникова В.М. Подготовка и ведение беременности у женщин с привычным невынашиванием: методические пособия и клинические протоколы. М.: МЕДпресс-информ; 2010. 224с. [Sidelnikova V.M. Preparation and management of pregnancy in women with habitual miscarriage: methodological aids and clinical protocols. Moscow: MEDpress-inform; 2010. 224p. (in Russian)]

34. Менжинская И.В., Кашенцева М.М., Ванько Л.В., Сухих Г.Т. Иммунохимические свойства аутоантител к хорионическому гонадотропину у женщин с невынашиванием беременности. Иммунология. 2015; 36(1): 30-5. [Menzhinskaya I.V., Kashentseva M.M., Vanko L.V., Suhih G.T. Immunochemical properties of autoantibodies to chorionic gonadotropin in women with miscarriage. Immunologiya. 2015; 36(1): 30-5. (in Russian)]

35. Менжинская И.В., Безнощенко О.С., Кирющенков П.А., Ванько Л.В. Клиническое значение аутоантител к гонадотропным гормонам при нарушениях репродуктивной функции у женщин. Акушерство и гинекология. 2011; 1: 47-51. [Menzhinskaya I.V., Beznoshchenko O.S., Kiryushchenkov P.A., Vanko L.V. The clinical value of gonadotropic hormone autoantibodies in female reproductive dysfunction. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2011; 1: 47-51. (in Russian)]

36. Di Renzo G.C., Giardina I., Clerici G., Brillo E., Gerli S. Progesterone in normal and pathological pregnancy. Horm. Mol. Biol. Clin. Investig. 2016; 27(1): 35-48.

37. Pluchino N., Drakopoulos P., Wenger J.M., Petignat P., Streuli I., Genazzani A.R. Hormonal causes of recurrent pregnancy loss (RPL). Hormones (Athens). 2014; 13(3): 314-22.

38. Itsekson A., Lazarov A., Cordoba M., Zeitune M., Abraham D., Seidman D.S. Premenstrual syndrome and associated skin diseases related to hypersensitivity to female sex hormones. J. Reprod. Med. 2004; 49(3): 195-9.

39. Itsekson A.M., Seidman D.S., Zolti M., Lazarov A., Carp H.J. Recurrent pregnancy loss and inappropriate local immune response to sex hormones. Am. J. Reprod. Immunol. 2007; 57(2): 160-5.

40. Roby R.R., Richardson R.H., Vojdani A. Hormone allergy. Am. J. Reprod. Immunol. 2006; 55(4): 307-13.

41. Cheesman K.L., Gaynor L.V., Chatterton R.T. Jr., Radvany R.M. Identification of a 17-hydroxyprogesterone-binding immunoglobulin in the serum of a woman with periodic rashes. J. Clin. Endocrinol. Metab. 1982; 55(3): 597-9.

42. Itsekson A.M., Seidman D.S., Zolti M., Alesker M., Carp H.J. Steroid hormone hypersensitivity: clinical presentation and management. Fertil. Steril. 2011; 95(8): 2571-3.

43. Mabray C.R., Burditt M.L., Martin T.L., Jaynes C.R., Hayes J.R. Treatment of common gynecologic-endocrinologic symptoms by allergy management procedures. Obstet. Gynecol. 1982; 59(5): 560-4.

44. Juang C.M., Chou P., Yen M.S., Twu N.F., Horng H.C., Hsu W.L. Primary dysmenorrhea and risk of preterm delivery. Am. J. Perinatol. 2007; 24(1): 11-6.

45. Prieto-Garcia A., Sloane D.E., Gargiulo A.R., Feldweg A.M., Castells M. Autoimmune progesterone dermatitis: clinical presentation and management with progesterone desensitization for successful in vitro fertilization. Fertil. Steril. 2011; 95(3): 1121. e9-13.

46. Shelley W.B., Shelley E.D., Talanin N.Y., Santoso-Pham J. Estrogen dermatitis. J. Am. Acad. Dermatol. 1995; 32(1): 25-31.

47. Snyder J.L., Krishnaswamy G. Autoimmune progesterone dermatitis and its manifestation as anaphylaxis: a case report and literature review. Ann. Allergy Asthma Immunol. 2003; 90(5): 469-77.

48. Farage M.A., Berardesca E., Maibach H. The possible relevance of sex hormones on irritant and allergic responses: their importance for skin testing. Contact Dermatitis. 2010; 62(2): 67-74.

49. Cheesman K.L., Chatterton R.T. Jr. Effects of antiprogesterone antiserum on serum and ovarian progesterone, gonadotropin secretion, and pregnancy in the rat. Endocrinology. 1982; 111(2): 564-71.

50. Wang M.W., Heap R.B., Taussig M.J. Blocking of pregnancy in mice by immunization with anti-idiotype directed against monoclonal anti-progesterone antibody. Proc. Natl. Acad. Sci. USA. 1989; 86(18): 7098-102.

51. Ellaithy M.I., Fathi H.M., Farres M.N., Taha M.S. Skin test reactivity to female sex hormones in women with primary unexplained recurrent pregnancy loss. J. Reprod. Immunol. 2013; 99(1-2): 17-23.

52. Itsekson A.M., Soriano D., Zolti M., Seidman D.S., Carp H.J. Intradermal sex hormone desensitization for relief of premenstrual symptoms may improve the obstetric outcome of women with recurrent pregnancy loss. Gynecol. Endocrinol. 2013; 29(2): 169-72.

53. Foer D., Buchheit K.M., Gargiulo A.R., Lynch D.M., Castells M., Wickner P.G. Progestogen hypersensitivity in 24 cases: diagnosis, management, and proposed renaming and classification. J. Allergy Clin. Immunol. Pract. 2016;4(4): 723-9.

54. Гладкова К.А., Менжинская И.В., Сухих Г.Т., Сидельникова В.М. Роль сенсибилизации к прогестерону в клинике привычного невынашивания беременности. Проблемы репродукции. 2007; 13(6): 95-8. [Gladkova K.A., Menzhinskaya I.V., Suhih G.T., Sidelnikova V.M. The role of sensitization to progesterone in the clinic of habitual miscarriage. Problemyi reproduktsii. 2007; 13(6): 95-8. (in Russian)]

55. Мандрыкина Ж.А., Менжинская И.В., Озерова Р.И., Рора Л.С., Доброхотова Ю.Э., Сухих Г.Т. Аутосенсибилизация к гормонам при невынашивании беременности. Акушерство и гинекология. 2009; 6: 14-6. [Mandryikina Zh.A., Menzhinskaya I.V., Ozerova R.I., Rora L.S., Dobrohotova Yu.E., Suhih G.T. Autosensitization to hormones during miscarriage. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2009; 6: 14-6. (in Russian)]

Received 29.11.2016

Accepted 23.12.2016

About the Authors

Menzhinskaya Irina Vladimirovna, Ph.D., Senior Researcher, Laboratory of Clinical Immunology, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79153450659. E-mail: i_menzinskaya@oparina4.ru
Vanko Lyudmila Viktorovna, MD, Professor, Leading Researcher, Laboratory of Clinical Immunology, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79153053432. E-mail: LVanko@oparina4.ru

For citations: Menzhinskaya I.V., Vanko L.V. Association of antibodies
against gonadotropins and female sex hormones with reproductive disorders.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (9): 20-7. (in Russian)
http://dx.doi.org/10.18565/aig.2017.9.20-7

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