Thyroid autoimmunity and abortion: a prospective study in women undergoing in vitro fertilization

Müller, Alex F.; Verhoeff, Arie; Mantel, Mart J; Berghout, A

doi:10.1016/s0015-0282(98)00394-x

Cited by 100 publications

(58 citation statements)

References 14 publications

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“…Similarly, in a small group of women in an IVF program, no association was found between the presence of TPO antibodies before pregnancy and miscarriage. The presence of TPO antibodies before pregnancy did not diminish the chances to become pregnant (119). A systematic review and a meta-analysis confirmed the presence of maternal thyroid autoantibodies as a factor strongly associated with miscarriage and preterm delivery (120).…”

Section: European Journal Of Endocrinologymentioning

confidence: 82%

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Gaberšček

Zaletel

Schwetz

et al. 2015

European Journal of Endocrinology

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Thyroid disorders, especially Hashimoto's thyroiditis (HT), and polycystic ovary syndrome (PCOS) are closely associated, based on a number of studies showing a significantly higher prevalence of HT in women with PCOS than in controls. However, the mechanisms of this association are not as clear. Certainly, genetic susceptibility contributes an important part to the development of HT and PCOS. However, a common genetic background has not yet been established. Polymorphisms of the PCOS-related gene for fibrillin 3 (FBN3) could be involved in the pathogenesis of HT and PCOS. Fibrillins influence the activity of transforming growth factor beta (TGFb). Multifunctional TGFb is also a key regulator of immune tolerance by stimulating regulatory T cells (Tregs), which are known to inhibit excessive immune response. With lower TGFb and Treg levels, the autoimmune processes, well known in HT and assumed in PCOS, might develop. In fact, lower levels of TGFb1 were found in HT as well as in PCOS women carrying allele 8 of D19S884 in the FBN3 gene. Additionally, vitamin D deficiency was shown to decrease Tregs. Finally, high estrogen-to-progesterone ratio owing to anovulatory cycles in PCOS women could enhance the immune response. Harmful metabolic and reproductive effects were shown to be more pronounced in women with HT and PCOS when compared with women with HT alone or with controls. In conclusion, HT and PCOS are associated not only with respect to their prevalence, but also with regard to etiology and clinical consequences. However, a possible crosstalk of this association is yet to be elucidated.

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Section: European Journal Of Endocrinologymentioning

confidence: 82%

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Gaberšček

Zaletel

Schwetz

et al. 2015

European Journal of Endocrinology

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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%

“…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%

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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“…The studies differed in various aspects. Some had followed a cohort (235)(236)(237)248,250,252,253,(260)(261)(262)(263)(264)(265)(266)(267)(268)(269)(270)(271) (B,A,B,B,B,B,B,A,B-B) and others were "case-controlled" studies (251,254,(272)(273)(274)(275) (C,C,C,C,C).…”

Section: What Is the Role Of Thyroid Autoimmunity In Fertility And Prmentioning

confidence: 99%

Clinical practice guidelines for the management of hypothyroidism

Brenta

Vaisman

Sgarbi

et al. 2013

Arq Bras Endocrinol Metab

124

123

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Introduction: Hypothyroidism has long been known for its effects on different organ systems, leading to hypometabolism. However, subclinical hypothyroidism, its most prevalent form, has been recently related to cardiovascular risk and also to maternal-fetal complications in pregnant women. Objectives: In these clinical practice guidelines, several aspects of this field have been discussed with the clear objectives of helping physicians treat patients with hypothyroidism, and of sharing some of our Latin American-based clinical experience. Materials and methods: The Latin American Thyroid Society commissioned a Task Force on Hypothyroidism to develop evidence-based clinical guidelines on hypothyroidism. A systematic review of the available literature, focused on the primary databases of MedLine/PubMed and Lilacs/SciELO was performed. Filters to assess methodological quality were applied to select the best quality studies. The strength of recommendation on a scale from A-D was based on the Oxford Centre for Evidence--based Medicine, Levels of Evidence 2009, allowing an unbiased opinion devoid of subjective viewpoints. The areas of interest for the studies comprised diagnosis, screening, treatment and a special section for hypothyroidism in pregnancy. Results: Several questions based on diagnosis, screening, treatment of hypothyroidism in adult population and specifically in pregnant women were posed. Twenty six recommendations were created based on the answers to these questions. Despite the fact that evidence in some areas of hypothyroidism, such as therapy, is lacking, out of 279 references, 73% were Grade A and B, 8% Grade C and 19% Grade D. Conclusions: These evidence-based clinical guidelines on hypothyroidism will provide unified criteria for management of hypothyroidism throughout Latin America. Although most of the studies referred to are from all over the world, the point of view of thyroidologists from Latin America is also given. Arq Bras Endocrinol Metab. 2013;57(4):265-99

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Thyroid autoimmunity and abortion: a prospective study in women undergoing in vitro fertilization

Cited by 100 publications

References 14 publications

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

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

Clinical practice guidelines for the management of hypothyroidism

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