Interlayer exchange coupling (IEC) in fully epitaxial Fe/MgO/Fe(001) tunnel junctions with wedge-shaped MgO layers is measured at room temperature from the unidirectional shift of the Kerr hysteresis loop. It is found that the IEC is antiferromagnetic for small MgO thickness but changes sign at 0.8 nm. Ab initio calculations of IEC show that this behavior can be explained by the presence of O vacancies in the MgO barrier which makes IEC antiferromagnetic for thin barriers. With increasing MgO thickness the resonance contribution to IEC from localized defect states is reduced resulting in the ferromagnetic coupling typical for perfect MgO barriers.