unexplained infertility , sometimes also called idiopathic infertility , refers to the failure to conceive in a couple for whom no definitive cause of infertility can be found . generally , the duration of infertility is more than 2 years . approximately 1020% of couples who are unable to conceive are determined to have unexplained infertility . recurrent abortions are historically defined as three consecutive pregnancy losses before 20 weeks from the last menstrual period . at present , there exist a small number of accepted etiologies for recurrent abortions [ figure 1 ] . etiology for recurrent abortions ( adopted from khamashta and mackworth - young ) antiphospholipid antibodies ( apla ) are acquired autoantibodies directed to phospholipids that are associated with slow progressive thrombosis and infarction of the placenta . substances in blood called phospholipids are required for the blood to clot . in some people this reaction can be viewed as a confusion of the immune system , called an autoimmune process . apla represent a family of autoantibodies of different specificities , most of which are directed toward different anionic phospholipids which include cardiolipin , phosphatidylcholine , phosphatidylserine , phosphatidic acid , and phosphatidylethanolamine . though apla cause problems , surprisingly 215% of the healthy population actually have apla in their blood . however , these people have very low levels of the antibodies and , therefore , they do not really cause a problem . it is only when they are at high levels that apla begin to make trouble . apla are commonly found in people with unexplained infertility , lupus , migraine headache , deep vein thrombosis , and recurrent abortions . complications caused by apla include blood clotting , stroke , heart attack , miscarriage , and implantation failure . the present study was conducted in the department of biochemistry on 70 cases reporting in the department of obstetrics and gynaecology of a tertiary care centre in north india . these cases were in three groups - study group ( i ) ( n = 50 ) : group i ( a ) included 25 clinically confirmed cases of unexplained infertility of minimum 5 years duration and group i ( b ) included 25 clinically confirmed cases of recurrent abortions ; control group ( ii ) : included 20 healthy multipara females of same reproductive age group . approval of institutional ethics committee was procured . the cases of recurrent abortions and primary unexplained infertility were included . females with the previous history of tuberculosis , diabetes mellitus , cardiovascular disorder , thyroid disorders , polycystic ovarian disease , abnormal hormonal assay , infections ( torch , hiv ) , abnormal sonographic studies , cases of secondary infertility ( those who have had a previous conception ) , and cases of male infertility were excluded . apla estimation ( igg and igm ) was done using elisa kit method ( orgentec diagnostika - germany ) . antiphospholipid screen ( igg and igm ) is an elisa test system to screen for the presence of igg and igm class autoantibodies against phospholipids in human serum . the serum was then separated by centrifugation of the samples and was used for estimating apla . though the mean igm levels of apla in cases of primary infertility were raised compared to controls , p = 0.598 which was found to be statistically nonsignificant . similarly , the mean igg levels of apla in cases of primary infertility were raised compared to controls but p = 0.606 which was found to be statistically nonsignificant [ table 1 ] . igm and igg levels of antiphospholipid in primary infertility cases and controls in recurrent abortion cases , the mean igm levels of apla were raised compared to controls but p = 0.419 which was found to be statistically nonsignificant . similarly , the mean igg levels of apla in cases of recurrent abortions were raised compared to controls . mechanisms of apla - induced reproductive failure are not sufficiently well understood , but there is fetoplacental insufficiency , hypoxia and intrauterine fetal death . in vitro studies suggest that apla also act on trophoblasts at a very early stage by inhibiting syncytia formation . the role of apla in infertility and recurrent pregnancy loss has been the focus of several clinical trials . in our study , the mean levels of apla ( both igg and igm ) are raised in cases of infertility and recurrent abortions . normal levels of apla ( igg and igm ) were found in 84% of the patients of recurrent abortions and primary infertility . only 4 patients in each group ( 16% ) had levels higher than reference range . other authors have also studied the levels of apla in infertility and/or recurrent abortions [ table 3 ] . the studies of simpson et al . , couto et al . , chilcott et al . , and nekoo et al . corroborated our findings , i.e. , apla were raised but the results were statistically nonsignificant . in our study , apla were raised in four cases of recurrent abortions ( 16% ) and unexplained infertility ( 16% ) . however , the results were statistically nonsignificant . however , some studies ( sauer et al . and parke et al . ) found significant role of apla in cases of infertility and recurrent abortions . the mean levels of serum igg and igm were increased in both groups but were statistically nonsignificant , thus denying any role of raised apla in infertility and recurrent abortion cases . further studies with larger sample size are required to gather more evidence regarding the significance of apla in such cases .
background : antiphospholipid antibodies ( apla ) are acquired autoantibodies directed to phospholipids which are associated with slow progressive thrombosis and infarction of placenta . 
 infertility and recurrent pregnancy loss may occur because of impaired trophoblast function , placental infarction , and abnormal blood clotting.aim:to evaluate apla ( igg and igm ) in cases of infertility and recurrent abortions.materials and methods : a prospective study comprising 70 subjects was carried out . 
 fifty cases of unexplained infertility and recurrent abortions ( 25 each ) constituted the study group . 
 twenty healthy multipara females of same reproductive age group constituted the control group . 
 venous blood samples were collected , and serum was analyzed for two types of apla ( igg and igm ) by elisa method.results:the mean igm and igg levels in recurrent abortions group were 8.10 mpl - u / ml and 6.17 gpl - u / ml , respectively whereas in control group , the levels were 4.67 mpl - u / ml and 4.53 gpl - u / ml , respectively . the difference was statistically nonsignificant . 
 the mean igm and igg levels in unexplained infertility group were 7.30 mpl - u / ml and 6.12 gpl - u / ml , respectively whereas in control group , the levels were 4.67 mpl - u / ml and 4.53 gpl - u / ml , respectively . 
 again the difference was statistically nonsignificant.conclusions:the present study concludes that there is no significance of raised apla in cases of infertility and recurrent abortions .