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已发表论文
抗合成酶综合征体外受精患者不良妊娠结局：罕见病例的启示
Authors He M , Yu X, Wang L, Li R, Zhou X, Jike E, Zeng J, Wang F
Received 21 May 2025
Accepted for publication 25 September 2025
Published 10 October 2025 Volume 2025:17 Pages 3633—3640
DOI https://doi.org/10.2147/IJWH.S541914
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Matteo Frigerio
Mengjie He,1,* Xiaoyu Yu,2,* Li Wang,2 Rong Li,2 Xiaoju Zhou,3 Erniu Jike,3 Jiuzhi Zeng,2 Fei Wang1
1Department of Clinical Pharmacy, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’ s and Children’s Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 2Reproductive Medicine Center, Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 3School of Laboratory Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jiuzhi Zeng, Reproductive Medicine Center, Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China, Tel/Fax +86-28-65978242, Email zengjiuzhi9@163.com Fei Wang, Department of Clinical Pharmacy, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Chengdu, People’s Republic of China, Tel/Fax +86-28-65978526, +86-28-65978526, Email 1015964815@qq.com
Abstract: Anti-synthetase syndrome (ASS) is a rare autoimmune condition characterized by the presence of anti-aminoacyl tRNA synthetase (ARS) antibodies and systemic features such as interstitial lung disease and myositis. Although autoimmune disorders are known to affect fertility, the impact of ASS on assisted reproductive technology (ART) outcomes remains largely unexplored. We present the case of a 36-year-old woman with primary infertility and no prior autoimmune diagnosis. She underwent six in vitro fertilization (IVF) cycles marked by recurrent fertilization failure, cleavage-stage arrest with high fragmentation and poor grading and oocytes exhibiting a waxy zona pellucida (ZP). Her diminished ovarian reserve (DOR) (anti-Müllerian hormone: 0.351 ng/mL; antral follicle count: 5) was documented prior to ART. Following a rare successful embryo transfer, she developed severe ASS at 20 weeks of gestation, characterized by acute interstitial lung disease (ILD), anti-PL-12 antibody positivity, and myositis. These conditions progressed to life-threatening complications, ultimately necessitating pregnancy termination. This case suggests a possible link between ASS and ovarian dysfunction, potentially mediated by autoimmune injury to follicular structures, cytokine dysregulation, or anti-zona pellucida antibody interference. Moreover, pregnancy-associated immune shifts may exacerbate latent autoimmune activity. Screening for anti-synthetase antibodies could be beneficial in patients with unexplained infertility or recurrent ART failure.
Keywords: anti-synthetase syndrome, assisted reproduction, infertility, ovarian reserve, autoimmune infertility, pregnancy complications
1Department of Clinical Pharmacy, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’ s and Children’s Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 2Reproductive Medicine Center, Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 3School of Laboratory Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jiuzhi Zeng, Reproductive Medicine Center, Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China, Tel/Fax +86-28-65978242, Email zengjiuzhi9@163.com Fei Wang, Department of Clinical Pharmacy, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Provincial Women’s and Children’s Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Chengdu, People’s Republic of China, Tel/Fax +86-28-65978526, +86-28-65978526, Email 1015964815@qq.com
Abstract: Anti-synthetase syndrome (ASS) is a rare autoimmune condition characterized by the presence of anti-aminoacyl tRNA synthetase (ARS) antibodies and systemic features such as interstitial lung disease and myositis. Although autoimmune disorders are known to affect fertility, the impact of ASS on assisted reproductive technology (ART) outcomes remains largely unexplored. We present the case of a 36-year-old woman with primary infertility and no prior autoimmune diagnosis. She underwent six in vitro fertilization (IVF) cycles marked by recurrent fertilization failure, cleavage-stage arrest with high fragmentation and poor grading and oocytes exhibiting a waxy zona pellucida (ZP). Her diminished ovarian reserve (DOR) (anti-Müllerian hormone: 0.351 ng/mL; antral follicle count: 5) was documented prior to ART. Following a rare successful embryo transfer, she developed severe ASS at 20 weeks of gestation, characterized by acute interstitial lung disease (ILD), anti-PL-12 antibody positivity, and myositis. These conditions progressed to life-threatening complications, ultimately necessitating pregnancy termination. This case suggests a possible link between ASS and ovarian dysfunction, potentially mediated by autoimmune injury to follicular structures, cytokine dysregulation, or anti-zona pellucida antibody interference. Moreover, pregnancy-associated immune shifts may exacerbate latent autoimmune activity. Screening for anti-synthetase antibodies could be beneficial in patients with unexplained infertility or recurrent ART failure.
Keywords: anti-synthetase syndrome, assisted reproduction, infertility, ovarian reserve, autoimmune infertility, pregnancy complications