Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, 49 North Garden Rd, Beijing, 100191, China.
Clinical Epidemiology Research Center, Peking University Third Hospital, 49 North Garden Rd, Beijing, 100191, China.
J Assist Reprod Genet. 2021 Aug;38(8):2121-2128. doi: 10.1007/s10815-021-02204-2. Epub 2021 Apr 26.
We investigated the effect of different surgical procedures and radioactive iodine treatment (RAIT) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes and evaluated whether possible risk factors, including age, thyroid-stimulating hormone (TSH) levels, and thyroid antibody positivity, were associated with adverse IVF/ICSI outcomes.
This retrospective study included 76 women with infertility who had received thyroid cancer (TC) treatment among 137,698 infertile women who underwent IVF/ICSI cycles at the Peking University Third Hospital between 2010 and 2019. Clinical pregnancy and live birth rates were assessed.
We found that the clinical pregnancy and live birth rates in women who underwent partial thyroidectomy were 7- and 6-fold higher, respectively, than those in women who underwent total thyroidectomy. We observed no significant differences in the clinical pregnancy and live birth rates between the RAIT and non-RAIT groups, even after adjusting for age, TSH levels, surgical treatment, and thyroid antibody positivity. Multivariate logistic regression analysis showed that age and TSH levels were not associated with decreased clinical pregnancy and live birth rates. Women with thyroid antibody positivity had significantly lower clinical pregnancy and live birth rates than women without thyroid antibody positivity.
Our study showed lower clinical pregnancy and live birth rates in women who underwent total thyroidectomy than in women who underwent partial thyroidectomy. Thyroid antibody positivity is an important risk factor for adverse IVF/ICSI outcomes in women who have received TC treatment.
我们研究了不同手术程序和放射性碘治疗（RAIT）对体外受精/胞浆内精子注射（IVF/ICSI）结果的影响，并评估了包括年龄、促甲状腺激素（TSH）水平和甲状腺抗体阳性等可能的风险因素是否与不良 IVF/ICSI 结果相关。
这项回顾性研究纳入了 76 名在北京大学第三医院于 2010 年至 2019 年间接受 IVF/ICSI 周期治疗的 137698 名不孕女性中接受甲状腺癌（TC）治疗的女性。评估了临床妊娠率和活产率。
我们发现，部分甲状腺切除术组的临床妊娠率和活产率分别是全甲状腺切除术组的 7 倍和 6 倍。即使在调整了年龄、TSH 水平、手术治疗和甲状腺抗体阳性后，RAIT 组和非 RAIT 组之间的临床妊娠率和活产率也没有显著差异。多变量逻辑回归分析表明，年龄和 TSH 水平与临床妊娠率和活产率的降低无关。甲状腺抗体阳性的女性与甲状腺抗体阴性的女性相比，临床妊娠率和活产率显著降低。
我们的研究表明，与部分甲状腺切除术组相比，全甲状腺切除术组的女性临床妊娠率和活产率较低。甲状腺抗体阳性是接受 TC 治疗的女性不良 IVF/ICSI 结果的重要危险因素。
