[1]张育婧,范晶晶,丘文漪,等.甲状腺自身免疫抗体和促甲状腺激素对行体外受精/卵胞浆内单精子注射患者妊娠结局的影响[J].新乡医学院学报,2020,37(5):448-452.[doi:10.7683/xxyxyxb.2020.05.012]
　ZHANG Yujing,FAN Jingjing,QIU Wenyi,et al.Effect of thyroid autoimmune antibody and thyroid stimulating hormone on pregnancy outcomes of patients undergoing in vitro fertilization/intracytoplasmic sperm injection[J].Journal of Xinxiang Medical University,2020,37(5):448-452.[doi:10.7683/xxyxyxb.2020.05.012]
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甲状腺自身免疫抗体和促甲状腺激素对行体外受精/卵胞浆内单精子注射患者妊娠结局的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年5
页码:
448-452
栏目:
临床研究
出版日期:
2020-05-05

文章信息/Info

Title:
Effect of thyroid autoimmune antibody and thyroid stimulating hormone on pregnancy outcomes of patients undergoing in vitro fertilization/intracytoplasmic sperm injection
作者:
张育婧; 范晶晶; 丘文漪; 李红然; 梁琳琳; 于　岚; 王　璐; 何巧花
（河南大学人民医院，河南省人民医院生殖中心，河南　郑州　450003）
Author(s):
ZHANG Yujing; FAN Jingjing; QIU Wenyi; LI Hongran; LIANG Linlin; YU Lan; WANG Lu; HE Qiaohua
（Department of Reproductive Center,the People′s Hospital of Henan University，Henan Provincial People′s Hospital,Zhengzhou 450003，Henan Province,China）
关键词:
甲状腺抗体; 促甲状腺激素; 体外受精/卵胞浆内单精子注射; 不孕; 流产
Keywords:
antithyroid antibody; thyroid stimulating hormone; in vitro fertilization/intracytoplasmic sperm injection; infertility; abortion
分类号:
R711.2
DOI:
10.7683/xxyxyxb.2020.05.012
文献标志码:
A
摘要:
目的　探究甲状腺自身抗体（ATA）与血清促甲状腺激素（TSH）对体外受精/卵胞浆内单精子注射（IVF/ICSI）患者妊娠结局的影响。方法　选择2016年9月至2017年12月在河南省人民医院生殖中心首次接受IVF/ICSI助孕的1 221例患者为研究对象，根据血清TSH水平（以2.5 mU·L-1为分界）及ATA状态将患者分为4组。A组（n=649）：0.3 mU·L-1≤TSH<2.5 mU·L-1， ATA(-)；B组(n=106)：0.3 mU·L-1≤TSH<2.5 mU·L-1，ATA(+)；C组(n=378)：2.5 mU·L-1≤TSH≤4.2 mU·L-1，ATA（-）；D组(n=88)：2.5 mU·L-1≤TSH≤4.2 mU·L-1，ATA（+）。比较4组患者的基本资料和临床妊娠结局。结果　4组患者的促性腺激素(Gn)总剂量、Gn应用时间、人绒毛膜促性腺激素(HCG)日雌二醇、HCG日孕激素、移植日内膜厚度、获卵数、受精卵数、正常卵裂数、移植胚胎数、受精率比较差异均无统计学意义（P＞0.05），4组患者种植率、临床妊娠率、多胎率、早期流产率、晚期流产率及活产率比较差异均无统计学意义（P＞0.05）。Logistic回归分析显示，TSH、 ATA（+）均与临床妊娠、多胎妊娠、流产（早期流产、晚期流产）、活产无关（P＞0.05）。结论　患者在IVF/ICSI助孕治疗前血清TSH为2.5~4.2 mU·L-1且ATA（+）时，对临床妊娠结局无影响。
Abstract:
Objective　To investigate the effect of antithyroid antibodies(ATA) and serum thyroid stimulating hormone (TSH) on pregnancy outcome of patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).Methods　One thousand two hundred and twenty-one patients who received IVF/ICSI in the Reproductive Center of Henan Provincial People′s Hospital from September 2016 to December 2017 were selected as the study subjects.The patients were divided into four groups according to the serum level of TSH and ATA status.Group A（n=649）:0.3 mU·L-1≤TSH<2.5 mU·L-1 and ATA(-);Group B(n=106)：0.3 mU·L-1≤TSH<2.5 mU·L-1 and ATA(+);Group C(n=378)：2.5 mU·L-1≤TSH≤4.2 mU·L-1 and ATA（-）;Group D(n=88)：2.5 mU·L-1≤TSH≤4.2 mU·L-1 and ATA（+）.The differences in clinical data and pregnancy outcome were analyzed among the four groups.Results　There was no significant difference in the total dose of gonadotropin (Gn)，the total days of using Gn，estradiol on the human chorionic gonadotropin progesterone（HCG）day，progesterone on HCG day，the thickness of endometrium on the transplantation day，the number of eggs obtained，the number of fertilized eggs，the number of normal cleavage，the number of transferred embryos and the rate of fertilization among the four groups(P>0.05).There was no significant difference in the implantation rate ,fertilization rate，clinical pregnancy rate，multiple pregnancy rate，implantation rate，early abortion rate，late abortion rate and live birth rate among the four groups (P>0.05).Logistic regression analysis showed that TSH and ATA (+) were not related to clinical pregnancy，multiple pregnancy，early abortion rate，late abortion rate and live birth(P>0.05).Conclusion　The serum level of TSH is 2.5-4.2 mU·L-1 and ATA (+) can not effect the clinical pregnancy outcome of patients undergoing IVF/ICSI.

参考文献/References:

［1］　VAN DEN BOOGAARD E，VISSENBERG R，LAND J A，et al.Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy:a systematic review ［J］.Hum Reprod Update，2011，17(5):605-619.
［2］　UNUANE D，VELKENIERS B，BRAVENBOER B，et al.Impact of thyroid autoimmunity in euthyroid women on live birth rate after IUI ［J］.Hum Reprod，2017，32(4):1-8.
［3］　POPPE K，AUTIN C，VELTRI F，et al.Thyroid autoimmunity and intracytoplasmic sperm injection outcome:a systematic review and meta-analysis ［J］.J Clin Endocrinol Metab，2018，103(5):1755-1766.
［4］　LUKASZUK K，KUNICKI M，KULWIKOWSKA P，et al.The impact of the presence of antithyroid antibodies on pregnancy outcome following intracytoplasmatic sperm injection-ICSI and embryo transfer in women with normal thyreotropine levels ［J］.J Endocrinol Invest，2015，38(12):1335-1343.
［5］　ALEXANDER E K，PEARCE E N，BRENT G A，et al.2017 Guidelines of the american thyroid association for the diagnosis and management of thyroid disease during pregnancy and the postpartum ［J］.Thyroid，2017，27(3):315-389.
［6］　SWELLAM M，KHAIAL A，MOSA T，et al.Anti-mullerian and androgens hormones in women with polycystic ovary syndrome undergoing IVF/ICSI ［J］.Iran J Reprod Med，2013，11(11):883-890.
［7］　NEGRO R，SCHWARTZ A，GISMONDI R，et al.Increased regnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy ［J］.J Clin Endocrinol Metab，2010，95(9):E44-E48.
［8］　KIANPOUR M，AMINORROAYA A，AMINI M，et al.Thyroid-stimulating hormone (TSH) serum levels and risk of spontaneous abortion:a prospective population-based cohort study ［J］.Clin Endocrinol (Oxf)，2019，91(1):163-169.
［9］　ANGELA F，GIORGIO G，DANIELA R，et al.Thyroid function in infertile patients undergoing assisted reproduction ［J］.Am J Reprod Immunol，2014，70(4):336-341.
［10］　SEUNGDAMRONG A，STEINER A Z，GRACIA C R，et al.Preconceptional antithyroid peroxidase antibodies，but not thyroid-stimulating hormone，are associated with decreased live birth rates in infertile women ［J］.Fertil Steril，2017，108(5):843-850.
［11］　KARMON A E，MARIA B，CHAVARRO J E，et al.Preconceptional thyroid-stimulating hormone levels and outcomes of intrauterine insemination among euthyroid infertile women ［J］.Fertil Steril，2015，103(1):258-263.
［12］　CHAI J，YEUNG W Y，LEE C Y，et al.Live birth rates following in vitro fertilization in women with thyroid autoimmunity and/or subclinical hypothyroidism ［J］.Clin Endocrinol (Oxf)，2014，80(1):122-127.
［13］　PLOWDEN T C，SCHISTERMAN E F，SJAARDA L A，et al.Subclinical hypothyroidism and thyroid autoimmunity are not associated with fecundity，pregnancy loss or live birth ［J］.J Clin Endocrinol Metab，2016，101(6):2358-2365.
［14］　NAZARPOUR S，RAMEZANI T F，SIMBAR M，et al.Effects of levothyroxine on pregnant women with subclinical hypothyroidism，negative for thyroid peroxidase antibodies ［J］.J Clin Endocrinol Metab，2017，103(3):926-935.
［15］　GOLDBERG A S，SUJANA KUMAR S，GREENBLATT E，et al.Delaying thyroxine until positive beta-human chorionic gonadotropin is safe for patients receiving fertility therapy:applying new ATA guidelines to subclinical hypothyroidism ［J］.J Obstet Gynaecol Can，2018，40(3):299-303.
［16］　LU H，HUANG Y，XIN H，et al.The expression of cytokines IFN-gamma，IL-4，IL-17A，and TGF-beta1 in peripheral blood and follicular fluid of patients testing positive for anti-thyroid autoantibodies and its influence on in vitro fertilization and embryo transfer pregnancy outcomes ［J］.Gynecol Endocrinol，2018，34(11):933-939.
［17］　MONTELEONE P，PARRINI D，FAVIANA P，et al.Female infertility related to thyroid autoimmunity:the ovarian follicle hypothesis ［J］.Am J Reprod Immunol，2011，66(2):108-114.
［18］　BUSNELLI A，PAFFONI A，FEDELE L，et al.The impact of thyroid autoimmunity on IVF/ICSI outcome:a systematic review and meta-analysis ［J］.Hum Reprod Update，2016，22(6):775.
［19］　KARACAN M，ALWAEELY F，CEBI Z，et al.Effect of antithyroid antibodies on ICSI outcome in antiphospholipid antibody-negative euthyroid women ［J］.Reprod Biomed Online，2013，27(4):376-380.
［20］　ZHONG Y P ，YING Y ，WU H T,et al.Relationship between antithyroid antibody and pregnancy outcome following in vitro fertilization and embryo transfer ［J］.Int J Med Sci，2012，9(2):121-125.
［21］　REVELLI A，CASANO S，PIANE D L，et al.A retrospective study on IVF outcome in euthyroid patients with anti-thyroid antibodies:effects of levothyroxine，acetyl-salicylic acid and prednisolone adjuvant treatments ［J］.Reprod Biol Endocrinol，2009，7(1):1-6.

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更新日期/Last Update: 2020-05-05