Anti‐thyroid Antibodies and Antiphospholipid Syndrome: Evidence of Reduced Fecundity and of Poor Pregnancy Outcome in Recurrent Spontaneous Aborters

Carolis, Caterina De; Greco, Elisabetta; Guarino, Maria Domenica; Perricone, Carlo; Lago, Alessandro Dal; Giacomelli, Roberto; Fontana, Luigi; Perricone, Roberto

doi:10.1111/j.1600-0897.2004.00215.x

Cited by 73 publications

(66 citation statements)

References 23 publications

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“…Four studies were excluded because TAI status had not been determined (24)(25)(26) or women with TAI had been excluded (27). Three studies were excluded because women with recurrent spontaneous miscarriages had been recruited (28)(29)(30) and another three studies because the IVF outcome had not been recorded or presented (14,31,32).…”

Section: Search Resultsmentioning

confidence: 99%

Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing IVF: a meta-analysis

Toulis¹,

Goulis²,

Venetis³

et al. 2010

European Journal of Endocrinology

145

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Objective: To investigate whether thyroid autoimmunity (TAI) is associated with increased risk for spontaneous miscarriage in subfertile, euthyroid women undergoing IVF. Design: Meta-analysis of observational studies. Patient(s): Four prospective studies that reported data on 1098 subfertile women undergoing IVF (141 with TAI and 957 controls) were included in the meta-analysis. Main outcome measure: Miscarriage risk ratio (RR). Secondary outcome measures: Clinical pregnancy rate and delivery rate. Result(s): Euthyroid, subfertile women with TAI undergoing IVF demonstrated significantly higher risk for miscarriage compared with controls (four studies-fixed effects RR: 1.99, 95% confidence interval: 1.42-2.79, P!0.001). No significant difference in clinical pregnancy and delivery rates was detected between groups. Conclusion: Based on the currently available evidence, it appears that the presence of TAI is associated with an increased risk for spontaneous miscarriage in subfertile women achieving a pregnancy through an IVF procedure.

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Section: Search Resultsmentioning

confidence: 99%

Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing IVF: a meta-analysis

Toulis¹,

Goulis²,

Venetis³

et al. 2010

European Journal of Endocrinology

145

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“…We included in the TAI group women with both normal and impaired thyroid function in accordance with the idea that the presence of anti-thyroid autoantibodies could represent the main factor leading to an increased risk of reproductive failure even in the absence of clinically overt hypothyroidism. [22][23][24][25][26]35,41,42 In this view, the presence of thyroid autoantibodies can reflect a generalized activation of the immune system with a possible disregulation of local inflammatory process at placental-decidual environment being relevant to the clinical outcome. 26 As increasing maternal age has been reported as an "independent" risk factor for infertility/RSA, we examined the difference in the mean age of women with TAI, SCH, or ET and no significant difference was found between the groups.…”

Section: Discussionmentioning

confidence: 99%

“…The meaning of these interesting findings was in accordance with the evidence supporting the role of thyroid function in the pathogenesis of many autoimmune disorders even in the absence of defined thyroid autoimmunity. 23,42,43 Assuming that infertile/RSA women have an overactive immune system, an increased prevalence of thyroid abnormalities could be expected mainly in terms of autoimmunity (TPO and ATG antibodies). 43 However, we observed that non-autoimmune thyroid dysfunction (such as SCH) is the more frequent condition among the infertile/RSA women and that SCH infertile/RSA women more frequently showed abnormal NK cells than TAI or ET women.…”

Section: Discussionmentioning

confidence: 99%

“…[19][20][21] Moreover, it has been reported that the presence of thyroid autoimmunity (TAI) leads to an increased risk of infertility and RSA even in the absence of clinically overt hypothyroidism. [23][24][25][26] Abnormalities in number and activation of NK cells have been related to RSA and several studies aimed at addressing the cutoff values for peripheral blood NK cell levels in this context. [27][28][29][30][31][32] Elevated levels of peripheral blood NK cells were reported in the presence of TAI in women with RSA suggesting an interplay between NK cells and autoimmune thyroid disorders.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Peripheral blood natural killer cells and mild thyroid abnormalities in women with reproductive failure

Triggianese

Perricone

Conigliaro

et al. 2015

Int J Immunopathol Pharmacol

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Abnormalities in peripheral blood natural killer (NK) cells have been reported in women with primary infertility and recurrent spontaneous abortion (RSA) and several studies have been presented to define cutoff values for abnormal peripheral blood NK cell levels in this context. Elevated levels of NK cells were observed in infertile/RSA women in the presence of thyroid autoimmunity (TAI), while no studies have been carried out, to date, on NK cells in infertile/ RSA women with non-autoimmune thyroid diseases. The contribution of this study is two-fold: (1) the evaluation of peripheral blood NK cell levels in a cohort of infertile/RSA women, in order to confirm related data from the literature; and (2) the assessment of NK cell levels in the presence of both TAI and subclinical hypothyroidism (SCH) in order to explore the possibility that the association between NK cells and thyroid function is not only restricted to TAI but also to SCH. In a retrospective study, 259 age-matched women (primary infertility [n = 49], primary RSA [n = 145], and secondary RSA [n = 65]) were evaluated for CD56+CD16+NK cells by flow cytometry. Women were stratified according to thyroid status: TAI, SCH, and without thyroid diseases (ET). Fertile women (n = 45) were used as controls. Infertile/RSA women showed higher mean NK cell levels than controls. The cutoff value determining the abnormal NK cell levels resulted ⩾15% in all the groups of women. Among the infertile/RSA women, SCH resulted the most frequently associated thyroid disorder while no difference resulted in the prevalence of TAI and ET women between patients and controls. A higher prevalence of women with NK cell levels ⩾15% was observed in infertile/RSA women with SCH when compared to TAI/ET women. According to our data, NK cell assessment could be used as a diagnostic tool in women with reproductive failure and we suggest that the possible association between NK cell levels and thyroid function can be described not only in the presence of TAI but also in the presence of non-autoimmune thyroid disorders.

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“…Some studies [68,69] but not all [70,71], have also found associations between thyroid autoimmunity and increased rates of recurrent miscarriage.…”

Section: Thyroid Auto-immunitymentioning

confidence: 99%

11 Hypothyroidism in Pregnancy

Lazarus¹,

Pīrāgs²,

Butz³

2009

The Thyroid and Reproduction

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Anti‐thyroid Antibodies and Antiphospholipid Syndrome: Evidence of Reduced Fecundity and of Poor Pregnancy Outcome in Recurrent Spontaneous Aborters

Abstract: Thyroid autoimmunity is frequently present in APS recurrent aborters and is often associated with either reduced fecundity or with poor pregnancy outcome. Thyroid antibodies should always be evaluated in women with RSA including those with aPL.

Cited by 73 publications

References 23 publications

Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing IVF: a meta-analysis

Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing IVF: a meta-analysis

Peripheral blood natural killer cells and mild thyroid abnormalities in women with reproductive failure

11 Hypothyroidism in Pregnancy

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