The effect of anti-thyroid antibodies on endometrial volume, embryo grade and IVF outcome

Kılıç, Sevtap; Taşdemir, Nicel; Yılmaz, Nafiye; Yüksel, Beril; Gül, Ayhan; Batıoğlu, Sertaç

doi:10.1080/09513590802531112

Cited by 66 publications

(62 citation statements)

References 23 publications

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“…Finally, four studies were included in the meta-analysis (10)(11)(12)(13)18). Disagreement between reviewers was recorded on whether multiple IVF procedures were involved in some of the included studies (10,11,13,18) and was resolved by consensus.…”

Section: Search Resultsmentioning

confidence: 99%

“…Etiology of infertility was reported to be similar in TAI groups in four studies (9,11,16,33), while three evaluated personal history of miscarriages as an exclusion criterion (9,10,13). Thus, the potential confounding effect of other causes of spontaneous miscarriages could not be neglected.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies (generally the most recent) applied RIA for the measurements (five studies), whereas electrochemiluminescence assays (ECL), enzyme immunoassays, ELISA, indirect passive agglutination, and radioligand assays were also used with various thresholds (further details in Table 1). In one study, sera were drawn 14 days after ET (16), and in another, no relevant information was provided (10).…”

Section: Systematic Reviewmentioning

confidence: 99%

“…Currently, it is not clear whether there is an association between TAI and poor IVF outcome (5,7). Several studies which examined the association between TAI status and miscarriage provided rather controversial results (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), although it appears that 'TAI per se does not alter the implantation of embryo' (19). Moreover, observations regarding TAI and miscarriage risk from the general population could not be applied to an IVF setting and vice versa, since women undergoing IVF are considered as a distinct subgroup, representing a 'special population' (20).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

143

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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%

Section: Discussionmentioning

confidence: 99%

Section: Systematic Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

143

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“…Hypothyroidism, both overt and subclinical, affects 3-5 % of reproductive-aged women [6,16]. The effects of overt hypothyroidism on fertility include impaired ovulation [13], lower clinical pregnancy rates after assisted reproductive technology (ART) [17], higher miscarriage rates [5] and poor obstetrical outcomes [1,4]. In early pregnancy, high human chorionic gonadotropin (HCG) levels stimulate thyroid function through their receptor homology.…”

Section: Introductionmentioning

confidence: 99%

Thyroid stimulating hormone levels rise after assisted reproductive technology

Reinblatt

Herrero

Correa

et al. 2013

J Assist Reprod Genet

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Purpose The goal of this study was to determine whether high E2 levels after controlled ovarian hyperstimulation affect TSH. Methods Patients completing ART cycles between AprilOctober 2010 were eligible for this cohort study. 180 patients were recruited however those with known thyroid disease were excluded. The final analysis included 154 subjects. Blood was collected at each visit during the ART cycle as well as at the pregnancy test. Samples were frozen at −20°C and analyzed together for E2 and TSH using the same assay kit once all patients had completed their cycles. All participants were treated at the McGill University Health Center. A paired t-test was used to study the difference in TSH levels recorded at maximal and minimal Estradiol levels during ovarian stimulation. Multiple regression analysis was then used to determine if factors such as anti-thyroid antibodies and ovarian reserve measures affect this change in TSH. We used multiple imputation methods to account for missing data. Results As E2 levels rose from low to supra-physiologic levels during treatment, TSH levels also rose significantly. This increase was clinically significant by the time of pregnancy test. The factors that potentially affected the change in TSH were: male factor/tubal factor infertility, type of protocol used as well as the presence of thyroid antibodies. Conclusions Although TSH increases during ART, this change only becomes clinically significant on the day of pregnancy test. Future studies should examine TSH changes specifically in certain "at-risk" sub-groups such as those with antibodies and known thyroid disease.Capsule As estradiol levels rise during ART, TSH also rises. This rise may be affected by: cause of infertility, type of protocol used as well as the presence of anti-thyroid antibodies.

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High level of thyroid peroxidase antibodies as a detrimental risk of pregnancy outcomes in euthyroid women undergoing ART: A meta‐analysis

Zhang

Yang

et al. 2023

Molecular Reproduction Devel

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Thyroid autoimmunity (TAI) triggered by genetic and epigenetic variation occurs mostly in women of reproductive age. TAI is described mainly by positivity of anti‐thyroid peroxidase antibody (TPO‐Ab) and/or thyroglobulin antibody (TG‐Ab). TPO‐Ab, but not TG‐Ab, was suggested to be associated with pregnancy outcome in euthyroid women undergoing assisted reproductive technology (ART), but their results are conflicting. This meta‐analysis was performed to decide whether the presence of TPO‐Ab—in a concentration dependent manner—correlates with the success of ART. A systematic literature search was performed in the PubMed, Web of Science, and EMBASE databases for relevant articles published from January 1999 to April 2022, and these studies focused on the effect of TAI on pregnancy outcomes of women who underwent in vitro fertilization, intracytoplasmic sperm injection and intrauterine insemination and met the inclusion criteria: (i) the studies were prospective or retrospective study; (ii) all patients undergoing ART were tested for thyroid‐related antibodies; (iii) the assessed ART outcomes included miscarriage rate (MR) or delivery rate (DR). The exclusion criteria were: (i) female congenital uterine malformation, chromosomal diseases and other infectious diseases; (ii) overt hypothyroidism or pre‐existing thyroid disease; (iii) thrombus tendency. We divided the included patients into three groups according to the TPO‐Ab threshold they defined: (i) TPO‐Ab (−), threshold <34 IU/mL; (ii) TPO‐Ab‐34, threshold >34 IU/mL; (iii) TPO‐Ab‐100, threshold >100 IU/mL. We then extracted necessary relevant data, including MR and DR. Egger's test was used to evaluate the risk of publication bias. This meta‐analysis included a total of 7 literatures involving 7466 patients with TAI (−) and 965 patients with TAI (+) and revealed that there was no significant difference between group TPO‐Ab‐34 and group TPO‐Ab (−) in MR [risk ratio (RR): 0.61 (0.35, 1.08), p = 0.09] and DR [RR: 0.97 (0.83, 1.13), p = 0.69]. By contrast, compared to TPO‐Ab (−) group, TPO‐Ab‐100 patients showed markedly higher MR [RR: 2.12 (1.52, 2.96), p = 0.0046], and lower DR [RR: 0.66 (0.49, 0.88), p < 0.0001] with high degree of statistical significance. This meta‐analysis suggests that, for euthyroid patients, high level of TPO‐Ab (>100 IU/mL) could adversely influence the pregnancy outcome of ART.

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The effect of anti-thyroid antibodies on endometrial volume, embryo grade and IVF outcome

Cited by 66 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

Thyroid stimulating hormone levels rise after assisted reproductive technology

High level of thyroid peroxidase antibodies as a detrimental risk of pregnancy outcomes in euthyroid women undergoing ART: A meta‐analysis

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