Abstract

Infertility is a condition that affects a couple and is defined as the lack of conception after an arbitrary period of 12 months without use of any contraception. Approximately 15% of couples suffer from infertility worldwide. In half of cases infertility is caused by the female factor. Unfortunately, the etiology of infertility has remained unexplained in more than 20% of couples. Only every second infertile couple seeks medical advice. Regardless of constant improvement of pregnancy rate in assisted reproduction (in vitro fertilization, IVF), success rates are still around 30% per cycle.

Female ferti­lity can be affected by diseases or dysfunctions of the reproductive tract, the neuro­endocrine system and the immune system. Reproductive autoimmune failure can be associated with overall activation of the immune system or with immune system reactions directed specifically against ovarian antigens.

Autoimmune mechanisms as well as increased production of multiple autoantibodies are involved in such infertility disorders as premature ovarian failure, endometriosis, polycystic ovary syndrome, tubal factor infertility, unexplained infertility, repeatedly unsuccessful IVF attempts and may be responsible for the pathophysiology of preeclampsia or spontaneous abortions. There are contradicting data regarding the importance of certain antibodies which damage directly the preimplantation embryo, interfering with implantation process or formation of the placenta. Consequently, overall activation of the immune system in female infertility has been suggested, explaining the high prevalence of a variety of autoantibodies non-specific for infertility.