Łukaszuk K, Kunicki M, Kulwikowska P, Liss J, Pastuszek E, Jaszczołt M, Męczekalski B, Skowroński K
Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland.
INVICTA Fertility and Reproductive Center, Gdańsk, Poland.
J Endocrinol Invest. 2015 Dec;38(12):1335-43. doi: 10.1007/s40618-015-0377-5. Epub 2015 Aug 18.
The aim of our study was to investigate the impact of anti-thyroid peroxidase antibodies (Anti-TPO) on pregnancy outcome following the in vitro fertilization and embryo transfer (IVF-ET) in general groups and in subgroups divided according to AMH level and age.
A total of 114 patients positive for anti-thyroid peroxidase antibodies (Anti-TPO+ group) and 495 infertile women negative for anti-thyroid peroxidase antibodies (Anti-TPO- group) undergoing IVF with ICSI from April 2010 to April 2012 were analyzed retrospectively.
There were no significant differences in age, BMI, basal FSH, LH, AMH levels and duration of infertility between the two main groups. No significant differences in terms of the days of ovarian stimulation, estradiol level in day 8, total gonadotropin dose, number of oocytes retrieved, available embryos and blastocysts, number of embryos transferred nor in rates of fertilization, implantation, clinical pregnancy, live birth and abortion rate between two main groups were found. The only statistically significant difference among the groups with different anti-TPO antibodies levels was found in basal FSH concentration and BMI. Among the clinical outcomes of IVF with respect to the different anti-TPO levels, the only significant difference was found for the number of oocytes retrieved. Analysis of the baseline parameters in relationship to age categories and AMH levels found significant differences between women positive and negative for thyroid antibodies with respect to basal FSH and LH levels for women >37 years and for basal FSH in AMH <0.6 subgroup.
The present study reveals that patients with anti-TPO antibodies showed no significant differences in fertilization, implantation, pregnancy rates, live birth rates and no higher risk for miscarriage following IVF-ET when compared with those negative for anti-thyroid antibodies.
我们研究的目的是在总体人群以及根据抗缪勒管激素(AMH)水平和年龄划分的亚组中,探讨抗甲状腺过氧化物酶抗体(Anti-TPO)对体外受精-胚胎移植(IVF-ET)后妊娠结局的影响。
回顾性分析2010年4月至2012年4月期间接受卵胞浆内单精子注射(ICSI)的114例抗甲状腺过氧化物酶抗体阳性患者(Anti-TPO+组)和495例抗甲状腺过氧化物酶抗体阴性的不孕妇女(Anti-TPO-组)。
两个主要组在年龄、体重指数(BMI)、基础促卵泡生成素(FSH)、促黄体生成素(LH)、AMH水平和不孕持续时间方面无显著差异。在卵巢刺激天数、第8天雌二醇水平、总促性腺激素剂量、取卵数、可用胚胎和囊胚数、移植胚胎数以及受精率、着床率、临床妊娠率、活产率和流产率方面,两个主要组之间均未发现显著差异。不同Anti-TPO抗体水平组之间唯一具有统计学意义的差异在于基础FSH浓度和BMI。在IVF的不同抗TPO水平的临床结局中,唯一显著差异在于取卵数。分析与年龄类别和AMH水平相关的基线参数发现,甲状腺抗体阳性和阴性的女性在年龄>37岁时基础FSH和LH水平以及AMH<0.6亚组的基础FSH方面存在显著差异。
本研究表明,与抗甲状腺抗体阴性的患者相比,Anti-TPO抗体阳性的患者在IVF-ET后的受精、着床、妊娠率、活产率方面无显著差异,流产风险也没有更高。