Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China.
Front Endocrinol (Lausanne). 2023 May 8;14:1098975. doi: 10.3389/fendo.2023.1098975. eCollection 2023.
This prospective cohort study aimed to determine the impact of thyroid autoimmunity and total 25-hydroxyvitamin D concentration on early pregnancy outcomes in women undergoing fertilization/intracytoplasmic sperm injection who had intact thyroid function. The study included 1,297 women who underwent fertilization/intracytoplasmic sperm injection cycles, although only 588 patients received fresh embryo transfer. The study endpoints were clinical pregnancy, ongoing pregnancy, ectopic pregnancy, and early miscarriage rates. Our study found that the total 25-hydroxyvitamin D serum concentrations (0.001) and anti-Mullerian hormone levels (0.019) were lower among patients in the TAI group (n=518) than among those in the non-TAI group (n=779). Additionally, the study population in each group was divided into three subgroups according to the total vitamin D status based on clinical practice guidelines (deficient, <20 ng/mL; insufficient, 21-29 ng/mL; and sufficient, ≥30 ng/mL), TAI group: sufficient, n=144; insufficient, n=187; and deficient, n=187; non-TAI group: sufficient, n=329; insufficient, n=318, and deficient, n=133. In the TAI group, the number of good-quality embryos decreased in patients with vitamin D deficiency (0.007). Logistic regression analysis indicated that aging prevented women from achieving clinical (0.024) and ongoing pregnancy (0.026). The current findings suggest that patients with TAI had reduced serum vitamin D concentration. Furthermore, in the TAI group, the number of good-quality embryos decreased in patients with vitamin D deficiency. Finally, aging adversely impacted achieving clinical and ongoing pregnancy.
本前瞻性队列研究旨在确定甲状腺自身免疫和总 25-羟维生素 D 浓度对甲状腺功能正常的接受体外受精/卵胞浆内单精子注射的女性早期妊娠结局的影响。该研究纳入了 1297 名接受体外受精/卵胞浆内单精子注射周期的女性，但只有 588 名患者接受了新鲜胚胎移植。研究终点为临床妊娠、持续妊娠、异位妊娠和早期流产率。我们的研究发现，甲状腺自身免疫组（n=518）患者的总 25-羟维生素 D 血清浓度（0.001）和抗苗勒管激素水平（0.019）均低于非甲状腺自身免疫组（n=779）。此外，根据临床实践指南（缺乏，<20ng/mL；不足，21-29ng/mL；和充足，≥30ng/mL），将每个组的研究人群分为三组，甲状腺自身免疫组：充足，n=144；不足，n=187；缺乏，n=187；非甲状腺自身免疫组：充足，n=329；不足，n=318，缺乏，n=133。在甲状腺自身免疫组中，维生素 D 缺乏的患者优质胚胎数量减少（0.007）。Logistic 回归分析表明，年龄会阻碍女性获得临床妊娠（0.024）和持续妊娠（0.026）。目前的研究结果表明，甲状腺自身免疫患者的血清维生素 D 浓度降低。此外，在甲状腺自身免疫组中，维生素 D 缺乏的患者优质胚胎数量减少。最后，年龄对实现临床妊娠和持续妊娠有不利影响。
