Wang Xianping, Ding Xufeng, Xiao Xiao, Xiong Fang, Fang Rui
Department of Gynaecology and Obstetrics, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, Jiangsu 214400, P.R. China.
Department of Reproductive Health, Maternal and Child Health Care Hospital of Yixing, Wuxi, Jiangsu 214200, P.R. China.
Exp Ther Med. 2018 Oct;16(4):3077-3081. doi: 10.3892/etm.2018.6561. Epub 2018 Aug 2.
The aim of the present study was to explore the influence of positive simple thyroid peroxidase antibody (TPO-Ab) on female infertility. Venous blood was collected on an empty stomach from infertile female patients (all of whom were in line with the World Health Organization's diagnostic criteria for infertility) receiving treatments at The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from 2014 to 2017 to detect thyroid function and thyroid antibodies [thyroglobulin antibody (TG-Ab), TPO-Ab and thyroid microsome antibody (TM-Ab)]. A total of 529 patients with normal thyroid function, TG-Ab and TM-Ab were included in the present study; they were divided into the positive group (121 cases with positive TPO-Ab) and the negative group (408 cases with negative TPO-Ab). Comparisons of age, body mass index (BMI), basal hormone levels, irregular menstruation, tubal obstruction, premature ovarian failure (POF), endometriosis (EMT) and polycystic ovary syndrome (PCOS) between the two groups of patients were conducted in order to determine whether the differences were statistically significant. The incidence rate of EMT was 39.6% in the positive group and 17.1% in the negative group (P<0.05). The incidence rate of PCOS in the observation group was 43.9%, which was significantly higher than that of the control group (21.3%; P<0.01). The results revealed that the differences in age, BMI, basal hormone levels, irregular menstruation and POF between the two groups were not statistically significant (P>0.05). Finally, the factors that had statistical significance (EMT and PCOS) were stratified by different age groups to compare the incidence rate of positive results among the different age groups, thus concluding which age group was influenced to a greater extent by TPO-Ab. The results indicated that positive TPO-Ab may be associated with PCOS and EMT, though particularly with PCOS. Infertile PCOS patients aged 28-35 years old were influenced more by TPO-Ab than those in other age groups. Thus, it is recommended that thyroid autoantibodies are detected in infertile PCOS females aged 28-35 years old, and treatment should be administered as soon thereafter.
本研究旨在探讨单纯甲状腺过氧化物酶抗体（TPO-Ab）阳性对女性不孕的影响。于2014年至2017年，对在南京医科大学附属无锡妇幼保健院接受治疗的不孕女性患者（均符合世界卫生组织不孕症诊断标准）进行空腹静脉采血，检测甲状腺功能及甲状腺抗体[甲状腺球蛋白抗体（TG-Ab）、TPO-Ab和甲状腺微粒体抗体（TM-Ab）]。本研究共纳入529例甲状腺功能、TG-Ab及TM-Ab正常的患者；将其分为阳性组（121例TPO-Ab阳性）和阴性组（408例TPO-Ab阴性）。对两组患者的年龄、体重指数（BMI）、基础激素水平、月经不调、输卵管阻塞、卵巢早衰（POF）、子宫内膜异位症（EMT）及多囊卵巢综合征（PCOS）进行比较，以确定差异是否具有统计学意义。阳性组EMT发病率为39.6%，阴性组为17.1%（P<0.05）。观察组PCOS发病率为43.9%，显著高于对照组（21.3%；P<0.01）。结果显示，两组患者在年龄、BMI、基础激素水平、月经不调及POF方面的差异无统计学意义（P>0.05）。最后，将具有统计学意义的因素（EMT和PCOS）按不同年龄组进行分层，比较不同年龄组阳性结果的发生率，从而得出哪个年龄组受TPO-Ab影响更大。结果表明，TPO-Ab阳性可能与PCOS和EMT相关，尤其是与PCOS相关。28至35岁的不孕PCOS患者比其他年龄组受TPO-Ab的影响更大。因此，建议对28至35岁的不孕PCOS女性检测甲状腺自身抗体，并尽早进行治疗。
