Soheila Arefi - Assistant Professor, Reproduction Endocrinology & Embryology Department, Avesina Research Institute, Tehran,Iran
Mahmoud Jeddi Tehrani - Associate Professor, Departement of Immunology, Avesina Research Institute, Tehran, Iran.
Mohammad Mehdi Akhondi - Assistant Professor, Reproduction Endocrinology & Embryology Department, Avesina Research Institute, Tehran,Iran
Ali Reza Mousavi - Assistant Professor, Department of Social Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Science and Health Services, Tehran, Iran

Background: Auto antibodies to zona-pellucida (AZA) seem to be important autoantibodies implicated in reproduction, with substantial role in both endocrine and reproductive functions of thehuman ovary. There are some debates on the relation of AZA with infertility, repeated In Vitro Fertilization (IVF) attempts, and outcome of it. Objective: In this study, we assessed the presence of AZA in the follicular fluids (FFs) of womenwho underwent intra cytoplasmic sperm injection (ICSI), in relation to etiology of infertility and multiple puncture of ovaries.Materials and Methods: In this prospective study, follicular fluids were evaluated from 96 infertile women, (19-40 years old, 31.5±5.1), who were candidates for ICSI based on the etiology ofinfertility. From these 80 women had explained infertility whereas 16 had unexplained infertility. All FFs were evaluated for presence of AZA by ELISA test. Results: Twenty patients (20.8%) were positive for AZA in follicular fluid. In patients with unexplained infertility, AZA antibody in follicular fluid, was significantly higher than the group with proven etiology of infertility (p=0.001). In addition, 20.4 % of patients who had beenpunctured previously showed AZA in their FFs which is statistically similar to the patients who were punctured for the first time.Conclusions: The high incidence of AZA in infertile women, especially women with unexplained infertility has to be considered. Relation of the presence AZA and repeated puncture of ovaries is still debatable. Determinations of AZA are highly recommended in evaluation of infertile couplesespecially in patient with unexplained infertility.

Anti Zona Antibody, Multiple puncture of ovaries,Unexplained infertility