不孕症女性甲状腺自身抗体阳性率的系统评价和荟萃分析。

Prevalence of thyroid autoantibody positivity in women with infertility: a systematic review and meta-analysis.

机构信息

Reproductive Medicine Research Center, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi, China.

Reproductive Medicine Center, Maternity and Child Health Care of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.

出版信息

BMC Womens Health. 2024 Nov 27;24(1):630. doi: 10.1186/s12905-024-03473-6.

DOI:10.1186/s12905-024-03473-6

PMID:39604908

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11600930/

Abstract

BACKGROUND

Thyroid autoimmunity (TAI) is associated with infertility and complications during pregnancy. However, the prevalence of thyroid autoantibodies in women with infertility remains unclear due to variability in study designs, sample sizes, and populations. In this meta-analysis, we aimed to assess the prevalence of thyroid autoantibodies in women with infertility compared with that in healthy controls.

METHODS

Systematic searches were conducted across PubMed, Embase, Web of Science, and the Cochrane Library from inception to February 5, 2024. The inclusion criteria were women with infertility and those with autoimmune thyroid antibodies. Studies in which relevant data could not be extracted, randomized control trial reports, studies with non-original or duplicate data, and non-English articles were excluded. The main outcome was prevalence rate.

RESULTS

The worldwide pooled prevalence of thyroid autoantibody positivity was 20%. In contrast, a significantly higher TAI prevalence was noted in the population with infertility than in healthy controls (risk ratio [RR] = 1.51). Subgroup analyses indicated that TAI prevalence was higher in patients receiving both assisted reproductive technology (ART) and non-ART treatments than in healthy controls (RR = 1.37 and 3.06, respectively). TAI prevalence was also higher in the recurrent abortion and non-recurrent abortion groups of infertility than in healthy controls (RR = 1.80 and 1.39, respectively). Additionally, a higher TAI prevalence was found in the euthyroid and non-simple euthyroid groups than in the control group (RR = 2.77 and 1.43, respectively). The prevalence was significantly higher in cases of unexplained infertility, endometriosis, ovulation disorders, and fallopian tube factors among women with infertility than among the control group (RR = 1.53, 1.83, 1.42, and 2.00, respectively).

CONCLUSIONS

Thyroid autoantibodies are more prevalent in patients with infertility than in healthy controls. Given the presence of thyroid autoantibodies, screening patients with infertility is clinically important.

摘要

背景

甲状腺自身免疫（TAI）与不孕和妊娠期间的并发症有关。然而，由于研究设计、样本量和人群的不同，不孕妇女中甲状腺自身抗体的患病率尚不清楚。在这项荟萃分析中，我们旨在评估不孕妇女与健康对照组相比甲状腺自身抗体的患病率。

方法

从 2024 年 2 月 5 日起，对 PubMed、Embase、Web of Science 和 Cochrane Library 进行了系统检索。纳入标准为不孕妇女和自身免疫性甲状腺抗体妇女。排除了无法提取相关数据的研究、随机对照试验报告、非原始或重复数据的研究以及非英文文章。主要结局为患病率。

结果

全球范围内甲状腺自身抗体阳性的患病率为 20%。相比之下，不孕人群中 TAI 的患病率明显高于健康对照组（风险比[RR] = 1.51）。亚组分析表明，接受辅助生殖技术（ART）和非-ART 治疗的患者的 TAI 患病率均高于健康对照组（RR = 1.37 和 3.06）。不孕患者中反复流产和非反复流产组的 TAI 患病率也高于健康对照组（RR = 1.80 和 1.39）。此外，甲状腺功能正常和非单纯甲状腺功能正常组的 TAI 患病率均高于对照组（RR = 2.77 和 1.43）。不孕患者中不明原因不孕、子宫内膜异位症、排卵障碍和输卵管因素组的 TAI 患病率均高于对照组（RR = 1.53、1.83、1.42 和 2.00）。