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Antiphospholipid Antibodies Panel (APA)

• Introduction
• Indications for Testing
• Detection Method
• Interpretation of Test Results
• Specimen Collection and Shipping Requirements
• Turn around Time
• Cost
• Request Hard Copy
• References

Introduction
Antiphospholipid Antibodies (APA) are a group of organ nonspecific autoantibodies that bind to both anionic and zwitterionic phospholipids. Their presence has been associated with reproductive failure characterized clinically as recurrent pregnancy loss, unexplained infertility and infertility associated with endometriosis. Antiphospholipid antibodies have also been associated with thrombosis. The most consistently reported phenomenon is the association between recurrent pregnancy loss and the presence of APA; and treatment of APA positive women with heparin or prednisone and aspirin or intravenous immunoglobulin improves pregnancy outcome among these women in all studies published. Women who present for in vitro fertilization (IVF) have been consistently shown to have a high prevalence of APA, especially those with pelvic pathology such as endometriosis and pelvic adhesions. However, the relevance of the presence of APA to IVF outcome is controversial.

Indication for Testing
All patients experiencing two or more consecutive pregnancy losses, endometriosis, IVF failure suspected to represent implantation failure, premature ovarian failure, unexplained infertility, as well as patients who have systemic lupus erythematosus, or another collagen vascular disease should be tested for the presence of antiphospholipid antibodies (APA).

Detection Method
Phospholipid Antibodies to seven phospholipid antigens are detected using a solid-state ELISA Assay. The panel consists of 21 antiphospholipid antibodies that include IgG, IgM and IgA antibodies to cardiolipin, phosphatidylserine, phosphatidylinositol, phosphatidylethanolamine, phosphatidylcholine, phosphatidylglycerol, and phosphatidic acid.

Interpretation of Test Results
The thresholds have been calculated based on 400 healthy male and female individuals. Results reported as Negative, Borderline or Positive. A normal is negative.

Specimen Collection and Shipping Requirements

• Collect one (1) 10 ml red or tiger top ube.
• Ship at room temperature in prepaid FedEx mailers overnight, next day morning

Turn around Time
Processing of specimens begins immediately upon receipt at our facilities. Results are routinely available within 7 to 10 days and are initially faxed, then mailed to the requesting physician.

Cost
Included in our fees are specimen collection and shipping materials, all courier and shipping charges, telephone and written reports, and consultation with physicians. Please call 1-877-737-7652 for pricing information.

Request Hard Copy

References
Coulam CB, Kaider BD, Kaider AS, Janowicz P, Roussev RG. Antiphospholipid antibodies associated with implantation failure after IVF/ET. J Assist Reprod Genet 1997;14:603-608.

Coulam CB. The role of antiphospholipid antibodies in reproduction: questions and answers raised at the 18th annual meeting of the American Society of Reproductive Immunology. Am J Reprod Immunol 1999;41:1-4.

Kaider AS, Kaider BD, Janowicz PB, Roussev RG. Immunodiagnostic evaluation in women with reproductive failure. Am J Reprod Immunol 1999; 42: 335-346.

Sher G, Feinman M, Zouves C, Kuttner G, Maassarani G, Salem R, Matzner W, Ching W, Chong P. High fecundity rates following in-vitro fertilization and embryo transfer in antiphospholipid antibody seropositive women treated with heparin and aspirin. Am J Reprod Immunology 1998;39:391-394.

Kaider BD, Coulam CB, Roussev, R. Murine embryos as a direct target for some human autoantibodies in vitro. Hum Reprod 1999;10:2556-2561.