FRI0338 Hydroxychloroquine may help to improve the in vitro fertilization-embryo transfer outcomes in ana and ds-dna positive patients
Authors: F. Lian, J. Zhou, Y. Wang, H. Xu, X. Yang
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Assisted reproductive technology has helped a large quantity of couples having trouble in natural pregnancy. Failure of <i>in vitro</i> fertilization-embryo transfer (IVF-ET) may be attributed to ANA and ds-DNA. ANA+/anti-dsDNA was related to low-quality embryos, low clinical pregnancy, and early miscarriage rate.<sup>1</sup> Hydroxychloroquine (HCQ) is recommended preconceptionally and throughout pregnancy for patients with SLE, and was proved to benefit the patients with Antiphospholipid syndrome. For those women with positive ANA and ds-DNA, but haven't any symptoms related to lupus or any other autoimmune diseases, the treatment for improving reproductive outcomes was controversial. In the present study, we retrospectively reviewed 156 patients with positive ANA and ds-DNA who underwent IVF-ET, compared the efficacy among different therapeutic strategies and observed side effects of the medication. <h3>Objectives</h3> To assess the efficacy, safety and tolerability of HCQ as preconceptionally and throughout pregnancy therapy in the treatment of IVF-ET patients with positive ANA and ds-DNA. <h3>Methods</h3> We retrospectively reviewed 156 patients in the treatment of IVF-ET with positive ANA and ds-DNA but without any symptoms in south China from January 2010 to December 2016 who received prednisone or prednisone +HCQ as preconceptionally and throughout pregnancy therapy. Prednisone was administrated at a dose of 7.5 mg/day. HCQ was administrated at a dose of 0.2 twice a day. Details of the IVF-ET outcomes and side effects were collected. <h3>Results</h3> Of the 156 patients, no significance of demographic variables and reproductive related parameters such as duration of infertility, basal sex hormone, total Gn dose, E2 level on the day of HCG initiation, and number of retrieved oocytes was found among prednisone group (65 cases) and prednisone +HCQ group (91 cases). Fertilisation rate, implantation rate and clinical pregnancy rate were significantly higher in prednisone +HCQ group than in prednisone group, 75.8% vs 60.0%, p=0.017, 29.7% vs 15.4%, p=0.032, and 62.6% vs 47.7%, p=0.028, respectively. Abortion rate was lower in prednisone +HCQ group, 7.0% vs 12.9%, but not significantly. Clinical pregnancy rate was not associated the titers of ANA or ds-DNA. Low C3 was correlated with failure of implantation. None of the cases on prednisone or prednisone plus HCQ had side effects affecting the treatment course. <h3>Conclusions</h3> Combination of prednisone and HCQ may be more effective than solo treatment of prednisone for patients underwent IVF-ET with positive ANA and ds-DNA who had no clinical symptoms of autoimmune diseases. <h3>Reference</h3> [1] Fan J, Zhong Y, Chen C. Impacts of Anti-dsDNA Antibody on In Vitro Fertilization-Embryo Transfer and Frozen-Thawed Embryo Transfer. J Immunol Res. 2017;2017:8596181. <h3>Acknowledgements</h3> Project supported by Guangdong Natural Science Foundation<sup>No. 2016</sup>A030313217). <h3>Disclosure of Interest</h3> None declared