Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil.
Amare Clinic, Recife, PE, Brazil.
JBRA Assist Reprod. 2024 Jun 28;28(3):442-449. doi: 10.5935/1518-0557.20240032.
To compare the ovarian reserve of women of reproductive age with and without thyroid autoimmunity (TAI).
We performed a retrospective analysis of medical records from an assisted reproduction clinic from February 2017 to December 2021. Women aged between18 and 47 years with data on antithyroperoxidase and antithyroglobulin (anti-Tg) antibodies and assessment of ovarian reserve by anti-müllerian hormone (AMH) and antral follicle count (AFC) were included. Among the 188 participants included, 63 were diagnosed with TAI, and 125 had both antibodies negative. AMH and AFC were compared between groups. Subanalysis based on age, types of antibodies, and thyroid function markers were performed. In addition, bivariate analysis and regression models were used.
Overall, there was no difference in the median levels of AMH or AFC between the two groups. However, in the subgroup analysis by age, we observed a trend towards lower median levels of AMH in women over 39 years with TAI (0.9 ng/mL vs. 1.5 ng/mL, p=0.08). In a subanalysis according to antibodies, we found a significantly lower median AFC in the group with anti-Tg than in the group without this antibody (8.0 follicles vs. 11.5 follicles, p=0.036). We also found a significantly higher prevalence of anti-Tg in patients with low ovarian reserve compared to those with normal reserve (60.7% vs. 39.3%, p=0.038).
The ovarian reserve of women with TAI appears to be insidiously compromised over the years, with a decreased ovarian reserve in women with anti-Tg.
比较有和无甲状腺自身免疫（TAI）的育龄妇女的卵巢储备功能。
我们对 2017 年 2 月至 2021 年 12 月期间辅助生殖诊所的病历进行了回顾性分析。纳入年龄在 18 至 47 岁之间、有抗甲状腺过氧化物酶和抗甲状腺球蛋白（anti-Tg）抗体数据以及抗苗勒管激素（AMH）和窦卵泡计数（AFC）评估卵巢储备功能的女性。在纳入的 188 名参与者中，63 名被诊断为 TAI，125 名两种抗体均为阴性。比较两组间 AMH 和 AFC 的差异。进行了基于年龄、抗体类型和甲状腺功能标志物的亚组分析。此外，还进行了双变量分析和回归模型分析。
总体而言，两组间 AMH 或 AFC 的中位数水平无差异。然而，在按年龄进行的亚组分析中，我们观察到 TAI 组中 39 岁以上女性的 AMH 中位数水平呈下降趋势（0.9ng/mL 比 1.5ng/mL，p=0.08）。根据抗体进行的亚组分析中，我们发现抗-Tg 组的 AFC 中位数明显低于无该抗体组（8.0 个卵泡比 11.5 个卵泡，p=0.036）。我们还发现，低卵巢储备患者中抗-Tg 的患病率明显高于正常储备患者（60.7%比 39.3%，p=0.038）。
TAI 患者的卵巢储备功能似乎随着时间的推移逐渐受损，抗-Tg 患者的卵巢储备减少。
