D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, St. Petersburg 199034, Russia.
Medical Faculty, Saint Petersburg State University, St. Petersburg 199106, Russia.
Int J Mol Sci. 2023 Feb 28;24(5):4705. doi: 10.3390/ijms24054705.
Autoimmune thyroid disease (AITD) is one of the most common endocrinopathies and is more prevalent in women. It becomes evident that the circulating antithyroid antibodies that often follow AITD have effects on many tissues, including ovaries, and therefore that this common morbidity might have an impact on female fertility, the investigation of which is the aim of the present research. Ovarian reserve, ovarian response to stimulation and early embryo development in infertile patients with thyroid autoimmunity were assessed in 45 women with thyroid autoimmunity and 45 age-matched control patients undergoing infertility treatment. It was demonstrated that the presence of anti-thyroid peroxidase antibodies is associated with lower serum anti-Müllerian hormone levels and antral follicle count. Further investigation revealed the higher prevalence of sub-optimal response to ovarian stimulation in TAI-positive women, lower fertilization rate and lower number of high-quality embryos in this group of patients. The cut-off value for follicular fluid anti-thyroid peroxidase antibody affecting the above-mentioned parameters was determined to be 105.0 IU/mL, highlighting the necessity of closer monitoring in couples seeking infertility treatment with ART.
自身免疫性甲状腺疾病(AITD)是最常见的内分泌疾病之一,在女性中更为常见。显然,常伴随 AITD 的循环抗甲状腺抗体对许多组织都有影响,包括卵巢,因此这种常见的发病率可能会对女性生育能力产生影响,这正是本研究的目的。在 45 名患有甲状腺自身免疫的不孕患者和 45 名年龄匹配的接受不孕症治疗的对照患者中,评估了甲状腺自身免疫患者的卵巢储备、卵巢对刺激的反应和早期胚胎发育。结果表明,抗甲状腺过氧化物酶抗体的存在与血清抗苗勒管激素水平和窦卵泡计数降低有关。进一步的研究表明,在 TAI 阳性的女性中,卵巢刺激反应不佳的发生率更高,受精率更低,该组患者的优质胚胎数量也更少。确定卵泡液抗甲状腺过氧化物酶抗体影响上述参数的截断值为 105.0 IU/mL,这突出了在接受 ART 的不孕症夫妇中需要更密切的监测。