H-Y antibody titers are increased in unexplained secondary recurrent miscarriage patients and associated with low male : female ratio in subsequent live births

TY - JOUR

T1 - H-Y antibody titers are increased in unexplained secondary recurrent miscarriage patients and associated with low male : female ratio in subsequent live births

AU - Nielsen, H S

AU - Wu, F

AU - Aghai, Z

AU - Steffensen, Rudi Nora

AU - van Halteren, A G

AU - Spierings, E

AU - Christiansen, O B

AU - Miklos, D

AU - Goulmy, E

PY - 2010/11/1

Y1 - 2010/11/1

N2 - Background The birth of a boy is significantly more common than a girl prior to secondary recurrent miscarriage (SRM) and is associated with a poorer chance of a subsequent live birth. Children born after SRM are more likely to be girls. High-titer antisera specific for male antigens (H-Y) have been shown to arrest development of male bovine embryos efficiently. We consequently questioned the role of H-Y antibodies in women with SRM. Methods Serum samples from patients with unexplained SRM (n = 84), unexplained primary recurrent miscarriage (PRM) (n = 12) and healthy women (n = 37) were obtained. The samples were taken during pregnancy (gestational weeks 4-5) for 77 (80) of the patients. Enzyme-linked immunosorbent assay was used to detect immunoglobulin G antibodies that specifically recognized any of the five recombinant H-Y proteins (EIF1AY, RPS4Y1, ZFY, DDX3Y and UTY) and their H-X homologs. Results H-Y-specific antibodies were more frequent in SRM patients (46) compared with female controls (19, P = 0.004) and PRM patients (8, P = 0.01). The presence of H-Y antibodies in early pregnancy was associated with a low male: female birth ratio among the subsequent live births, as only 12 of children born to H-Y antibody-positive patients were boys compared with 44 boys born to H-Y antibody negative patients (P = 0.03). Conclusions The high frequency of H-Y antibody-positive SRM patients and the association between the presence of these antibodies in early pregnancy and the low number of male offspring, suggest that maternal immune responses against H-Y antigens can cause pregnancy losses. Further exploring these mechanisms may increase our understanding of unexplained SRM.

AB - Background The birth of a boy is significantly more common than a girl prior to secondary recurrent miscarriage (SRM) and is associated with a poorer chance of a subsequent live birth. Children born after SRM are more likely to be girls. High-titer antisera specific for male antigens (H-Y) have been shown to arrest development of male bovine embryos efficiently. We consequently questioned the role of H-Y antibodies in women with SRM. Methods Serum samples from patients with unexplained SRM (n = 84), unexplained primary recurrent miscarriage (PRM) (n = 12) and healthy women (n = 37) were obtained. The samples were taken during pregnancy (gestational weeks 4-5) for 77 (80) of the patients. Enzyme-linked immunosorbent assay was used to detect immunoglobulin G antibodies that specifically recognized any of the five recombinant H-Y proteins (EIF1AY, RPS4Y1, ZFY, DDX3Y and UTY) and their H-X homologs. Results H-Y-specific antibodies were more frequent in SRM patients (46) compared with female controls (19, P = 0.004) and PRM patients (8, P = 0.01). The presence of H-Y antibodies in early pregnancy was associated with a low male: female birth ratio among the subsequent live births, as only 12 of children born to H-Y antibody-positive patients were boys compared with 44 boys born to H-Y antibody negative patients (P = 0.03). Conclusions The high frequency of H-Y antibody-positive SRM patients and the association between the presence of these antibodies in early pregnancy and the low number of male offspring, suggest that maternal immune responses against H-Y antigens can cause pregnancy losses. Further exploring these mechanisms may increase our understanding of unexplained SRM.

U2 - 10.1093/humrep/deq242

DO - 10.1093/humrep/deq242

M3 - Journal article

SN - 0268-1161

VL - 25

SP - 2745

EP - 2752

JO - Human Reproduction

JF - Human Reproduction

IS - 11

ER -