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镁与甲状腺功能在体外受精(IVF)后早期妊娠中的作用:内分泌生理学的新进展。

The role of magnesium and thyroid function in early pregnancy after in-vitro fertilization (IVF): New aspects in endocrine physiology.

作者信息

Stuefer Sibilla, Moncayo Helga, Moncayo Roy

机构信息

WOMED, Karl-Kapferer-Strasse 5, 6020 Innsbruck, Austria.

出版信息

BBA Clin. 2015 Mar 5;3:196-204. doi: 10.1016/j.bbacli.2015.02.006. eCollection 2015 Jun.

Abstract

BACKGROUND

The initiation of a pregnancy is a process that requires adequate energetic support. Recent observations at our Institution suggest a central role of magnesium in this situation. The aim of this study was to evaluate magnesium, zinc, selenium and thyroid function as well as anti-Müllerian hormone in early pregnancy following in-vitro fertilization as compared to spontaneous successful pregnancies.

RESULTS

A successful outcome of pregnancy after IVF treatment was associated with 2 parameters: higher levels of anti-Müllerian hormone as well as higher levels of magnesium in the pre-stimulation blood sample. These two parameters, however, showed no correlation. Spontaneous pregnancies as well as pregnancies after IVF show a fall of magnesium levels at 2-3 weeks of gestation. This drop of magnesium concentration is larger following IVF as compared to spontaneous pregnancies. Parallel to these changes TSH levels showed an increase in early IVF-pregnancy. At this time point we also observed a positive correlation between fT4 and TSH. This was not observed in spontaneous pregnancies. Thyroid antibodies showed no correlation to outcomes.

CONCLUSIONS

In connection with the initiation of pregnancy following ovarian stimulation dynamic changes of magnesium and TSH levels can be observed. A positive correlation was found between fT4 and TSH in IVF pregnancies. In spontaneous pregnancies smaller increases of TSH levels are related to higher magnesium levels.

GENERAL SIGNIFICANCE

We propose that magnesium plays a role in early pregnancy as well as in pregnancy success independently from anti-Müllerian hormone. Neither thyroid hormones nor thyroid antibodies were related to outcome.

摘要

背景

怀孕的启动是一个需要充足能量支持的过程。我们机构最近的观察表明镁在这种情况下起着核心作用。本研究的目的是评估体外受精后早期妊娠与自然成功妊娠相比时的镁、锌、硒和甲状腺功能以及抗苗勒管激素。

结果

体外受精治疗后成功的妊娠结局与两个参数相关:刺激前血样中抗苗勒管激素水平较高以及镁水平较高。然而,这两个参数之间没有相关性。自然妊娠以及体外受精后的妊娠在妊娠2 - 3周时镁水平会下降。与自然妊娠相比,体外受精后镁浓度的下降幅度更大。与这些变化同时,体外受精早期妊娠时促甲状腺激素(TSH)水平升高。在这个时间点,我们还观察到游离甲状腺素(fT4)与TSH之间呈正相关。自然妊娠中未观察到这种情况。甲状腺抗体与妊娠结局无相关性。

结论

与卵巢刺激后妊娠启动相关,可以观察到镁和TSH水平的动态变化。在体外受精妊娠中发现fT4与TSH之间呈正相关。在自然妊娠中,TSH水平较小的升高与较高的镁水平相关。

一般意义

我们提出镁在早期妊娠以及妊娠成功中发挥作用,且独立于抗苗勒管激素。甲状腺激素和甲状腺抗体均与妊娠结局无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8988/4661571/95b3cc821d3f/gr1.jpg

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