Wang Jia-Wei, Liao Xiao-Xian, Li Tuo
Department of Obstetrics and Gynecology, Nantong Maternity and Child Health Care Hospital affiliated to Nantong University, Nantong226018, Jiangsu Province, China.
Department of endocrinology, Changzheng hospital, Naval Medical University, Shanghai200003, China.
J Transl Int Med. 2021 Jan 5;9(2):76-83. doi: 10.2478/jtim-2021-0001. eCollection 2021 Jun.
Thyroid autoimmunity (TAI) is prevalent in women of live-birthing age and has independently been associated with complications of fertility and pregnancy, in the case of spontaneous conception or after assisted reproductive technology (ART) treatment. However, it remains challenging to identify causation between infertility and TAI, even interventional trials looking at the impact of levothyroxine (LT4) treatment on fertility and pregnancy outcomes due to differences among study results which related to small scales, impropriate study designs, enrollment criteria of infertility cause and titer/hormone concentration measurements. Furthermore, many questions remain unsettled in ART management in AITD infertile women attempt pregnancy. Therefore, further observational and interventional trials are needed more comprehensive multiple-center, double blinded, and randomized.
甲状腺自身免疫（TAI）在育龄女性中普遍存在，并且在自然受孕或辅助生殖技术（ART）治疗后，已独立与生育和妊娠并发症相关。然而，确定不孕症与TAI之间的因果关系仍然具有挑战性，即使是关于左甲状腺素（LT4）治疗对生育和妊娠结局影响的干预试验，由于研究结果存在差异，这些差异与样本量小、研究设计不当、不孕症病因纳入标准以及滴度/激素浓度测量有关。此外，在AITD不孕女性尝试怀孕的ART管理中，许多问题仍未得到解决。因此，需要更全面的多中心、双盲和随机的进一步观察性和干预性试验。
