Kim C H, Chae H D, Kang B M, Chang Y S
Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Am J Reprod Immunol. 1998 Jul;40(1):2-8. doi: 10.1111/j.1600-0897.1998.tb00380.x.
To investigate whether antithyroid antibodies (ATAs) affect the pregnancy outcome in euthyroid women undergoing in vitro fertilization-embryo transfer (IVF-ET).
Thyroid peroxidase antibody (TPOA) and thyroglobulin antibody (TGA) were measured by radioligand assay kits that were used as ATAs in 79 patients with tubal or unexplained infertility who were enrolled in an IVF-ET program. Women who were positive for antinuclear antibody, lupus anticoagulant, anticardiolipin antibody, and rheumatoid factor were excluded from our study. The study group comprised 28 (29.1%) euthyroid women who were positive for TPOAs, TGAs, or both. Fifty-one euthyroid women without ATAs served as control subjects. The results were analyzed with linear regression analysis, Student's t-test, Mann-Whitney U test, Kruskal-Wallis analysis of variance, chi 2 test, and Fisher's exact test.
There were no significant differences between the study group and the control group in patient characteristics such as age, infertility duration, and hormonal profile. There were also no significant differences between the two groups with respect to the number of retrieved oocytes, the fertilization rate, the number of embryos frozen, and the number of embryos transferred. There were no correlations between ATA (TPOA and TGA) titers and the fertilization rate. The clinical pregnancy rate per cycle was significantly lower in the study group, with 26.3% (10/38), compared with 39.3% (35/89) in the control group. The biochemical pregnancy rate per cycle and the miscarriage rate were significantly higher in the study group, 18.4% (7/38) and 40.0% (4/10), respectively, compared with 5.6% (5/89) and 11.4% (4/35), respectively, in the control group. In the study group, both TPOA and TGA titers were significantly higher in the biochemical pregnancy group than in the clinical pregnancy group or the nonpregnancy group. In 10 women with ATAs who achieved pregnancy after IVF-ET, both TPOA and TGA titers were significantly higher in the miscarriage group than in the ongoing pregnancy/delivery group.
ATAs in euthyroid women with tubal or unexplained infertility have an association with a poor pregnancy outcome after IVF-ET treatment.
探讨抗甲状腺抗体（ATA）是否会影响接受体外受精 - 胚胎移植（IVF - ET）的甲状腺功能正常女性的妊娠结局。
采用放射配体分析试剂盒检测79例因输卵管因素或不明原因不孕而参加IVF - ET项目患者的甲状腺过氧化物酶抗体（TPOA）和甲状腺球蛋白抗体（TGA），将其作为ATA。抗核抗体、狼疮抗凝物、抗心磷脂抗体及类风湿因子阳性的女性被排除在本研究之外。研究组包括28例（29.1%）TPOA、TGA阳性或两者均阳性的甲状腺功能正常女性。51例无ATA的甲状腺功能正常女性作为对照。结果采用线性回归分析、学生t检验、曼 - 惠特尼U检验、Kruskal - Wallis方差分析、卡方检验和Fisher精确检验进行分析。
研究组与对照组在年龄、不孕时间和激素水平等患者特征方面无显著差异。两组在获卵数、受精率、冷冻胚胎数和移植胚胎数方面也无显著差异。ATA（TPOA和TGA）滴度与受精率之间无相关性。研究组每周期临床妊娠率显著低于对照组，分别为26.3%（10/38）和39.3%（35/89）。研究组每周期生化妊娠率和流产率显著高于对照组，分别为18.4%（7/38）和40.0%（4/10），而对照组分别为5.6%（5/89）和11.4%（4/35）。在研究组中，生化妊娠组的TPOA和TGA滴度均显著高于临床妊娠组或未妊娠组。在10例IVF - ET后妊娠的ATA阳性女性中，流产组的TPOA和TGA滴度均显著高于持续妊娠/分娩组。
输卵管因素或不明原因不孕的甲状腺功能正常女性的ATA与IVF - ET治疗后的不良妊娠结局有关。
