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ORIGINAL RESEARCH article

Front. Immunol.

Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders

Pregnancy outcomes in women with anti-β2-glycoprotein I/human leukocyte antigen-DR autoantibodies receiving assisted reproductive technology: A prospective cohort study

Provisionally accepted
Yosuke OnoYosuke Ono1Shinichiro WadaShinichiro Wada2Yuta KobayashiYuta Kobayashi2Maki OgiMaki Ogi1Yoshiyuki FukushiYoshiyuki Fukushi2Kenji TanimuraKenji Tanimura3Hisashi AraseHisashi Arase4OSAMU YoshinoOSAMU Yoshino1Hideto YamadaHideto Yamada2*
  • 1University of Yamanashi, Chuo, Japan
  • 2Teine Keijinkai Hospital, Sapporo, Japan
  • 3Kobe University Graduate School of Medicine, Kobe, Japan
  • 4World Premier International Immunology Frontier Research Center, Research Institute for Microbial Diseases, Osaka University, Suita, Japan

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Objective: This study aimed to assess whether anti-β2-glycoprotein I (β2GPI)/human leukocyte antigen (HLA)-DR autoantibodies are associated with pregnancy outcomes in women with infertility receiving assisted reproductive technology (ART) in relation to antithrombotic therapies. Methods: In this multicenter prospective cohort study, levels of anti-β2GPI/ HLA-DR autoantibodies were measured in 194 women with infertility, who subsequently received embryo transfer (ET). The rates of clinical pregnancy, biochemical pregnancy loss, live birth, and miscarriage were assessed in relation to antibody positivity and antithrombotic treatments. The primary outcome was to evaluate how antithrombotic treatments were associated with pregnancy outcomes in women with anti-β2GPI/HLA-DR antibodies receiving ART. The treatment modality for the antibody-positive group was determined for each ET at the discretion of the attending physician. Results: Finally, 30 women in the antibody-positive group and 123 in the antibody-negative group were analyzed. The prevalence of recurrent implantation failure in the antibody-positive group (40.0%, 12/30) was higher than that in the antibody-negative group (20.3%, 25/123; p =

Keywords: Autoantibody, β2-glycoprotein I, HLA-DR, Embryo Transfer, Implantation failure, Low dose aspirin, Unfractionated heparin, Pregnancy

Received: 11 May 2025; Accepted: 03 Nov 2025.

Copyright: © 2025 Ono, Wada, Kobayashi, Ogi, Fukushi, Tanimura, Arase, Yoshino and Yamada. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Hideto Yamada, yamada-hideto@keijinkai.or.jp

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material