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Acute immunomodulatory changes during controlled ovarian stimulation: evidence from the first trial investigating the short-term effects of estradiol on biomarkers and B cells involved in autoimmunity

  • Assisted Reproduction Technologies
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Abstract

Purpose

The aim of the present study was to evaluate the in vivo immunomodulatory effects of an acute short-term estradiol (E2) increase on serum levels of B cell-activating factor (BAFF), immunoglobulins (Ig), anti-nuclear antibodies (ANA), and the peripheral B cell phenotype.

Methods

We conducted, at the Infertility Center of the University of Padua, a prospective case–control study on a cohort of infertile normo-responder women (group-A, 63 patients) undergoing controlled ovarian stimulation (COS) compared with an age-matched cohort of normo-ovulatory healthy women (group-B, 39 patients). Three serial blood sample assays were conducted in both groups, at T0, hypothalamic suppression; T1, ovulation induction; and T2, βhCG test in group A, and at T0, 2nd day; T1, 14th day; and T2, 21st day of cycle in group B, and serum levels of E2 and BAFF, BAFF/E2 ratio, circulating IgM, IgG, and IgA, ANA titer, and peripheral B cell phenotype were measured. We compared group-A versus group-B in terms of absolute and E2 normalized values of BAFF at baseline (T0) to verify for possible differences between healthy and infertile women, at T1 to verify for possible differences occurring after spontaneous ovulation versus COS, and at T2 to evaluate differences in serum BAFF levels between pregnant versus non-pregnant patients (considering only group-A) and between non-pregnant women after spontaneous versus COS cycles (group-B versus group-A). In group-A, we also evaluated IgM, IgG, IgA levels, ANA titer, and peripheral B cell phenotype at T0 versus T1 versus T2.

Results

With the exception of E2 levels at T1 (as expected), no significant differences were found between the two groups for all outcome measures. In group-A, BAFF at T0 positively correlated with IgM levels; marginal zone CD19+/CD27+/IgD+ memory B cell compartment tended to be expanded at T1 when compared with T0.

Conclusions

Despite several mechanistic and clinical studies supporting a stimulatory role of E2 on autoimmunity, the acute increase of E2 during COS for infertility treatment does not seem to have a major impact on the immune system.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Medicine, University of Padua, Padua, Italy

    Anna Ghirardello, Marianna Beggio & Andrea Doria

  2. Department of Woman and Child Health, Gynaecologic and Obstetric Unit, University of Padua, Padua, Italy

    Salvatore Gizzo, Marco Noventa, Amerigo Vitagliano & Michele Gangemi

  3. Department of Laboratory Medicine, University of Padua, Padua, Italy

    Nicoletta Gallo, Giorgia Pantano, Chiara Cosma & Mario Plebani

  4. Department of Obstetrics and Gynaecology, University of Verona, Verona, Italy

    Michela Quaranta

  5. Dipartimento di Salute della Donna e del Bambino, U.O.C. di Ginecologia e Ostetricia, Via Giustiniani 3, 35128, Padova, Italy

    Salvatore Gizzo

Authors
  1. Anna Ghirardello
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  2. Salvatore Gizzo
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  3. Marco Noventa
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  4. Michela Quaranta
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  5. Amerigo Vitagliano
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  6. Nicoletta Gallo
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  7. Giorgia Pantano
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  8. Marianna Beggio
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  9. Chiara Cosma
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  10. Michele Gangemi
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  12. Andrea Doria
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Correspondence to Salvatore Gizzo.

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Additional information

Capsule The acute short-term estradiol (E2) increase during controlled ovarian stimulation do not seem to significantly affect serum levels of B cell-activating factor (BAFF), immunoglobulins (Ig), anti-nuclear antibodies (ANA), and the peripheral B cell phenotype.

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Ghirardello, A., Gizzo, S., Noventa, M. et al. Acute immunomodulatory changes during controlled ovarian stimulation: evidence from the first trial investigating the short-term effects of estradiol on biomarkers and B cells involved in autoimmunity. J Assist Reprod Genet 32, 1765–1772 (2015). https://doi.org/10.1007/s10815-015-0588-x

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  • DOI: https://doi.org/10.1007/s10815-015-0588-x

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