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Genetics and Immunology Reproductive Immunology

Relationship between antithyroid antibody and pregnancy outcome following in vitro fertilization and embryo transfer

Zhong YP, Ying Y, Wu HT, Zhou CQ, Xu YW, Wang Q, Li J, Shen XT

Published January 19, 2012 International Journal of Medical Sciences, 9(2), 121-125
DOI 10.7150/ijms.3467 PMID 22253557 PMC PMC3258552

RRM Academy Synopsis

Women with antithyroid antibodies had lower IVF pregnancy rates

In a retrospective study of 90 women with antithyroid antibodies and 676 without, women with antibodies had lower pregnancy rates after IVF. The pregnancy rate was about 33 out of 100 against about 47 out of 100. The abortion rate (pregnancy loss) was about 27 out of 100 against about 12 out of 100.

Key Findings

  • The study analyzed 90 women (156 cycles) with antithyroid antibodies and 676 women (1062 cycles) without, who had IVF or ICSI (IVF with sperm injection) from August 2009 to August 2010.
  • The fertilization rate was 64.3% in the antibody-positive group against 74.6% in the antibody-negative group. The implantation rate was 17.8% against 27.1%.
  • The pregnancy rate following IVF was 33.3% in the antibody-positive group against 46.7% in the antibody-negative group.
  • The abortion rate (pregnancy loss) was 26.9% in the antibody-positive group against 11.8% in the antibody-negative group.
  • The groups showed no significant difference in days of ovarian stimulation, total dose of stimulation medication, estradiol level on the day of hCG, or number of oocytes retrieved.

Interpretation

The study is a retrospective comparison at one university hospital. It describes an association between antibody status and IVF outcomes. The two groups were similar in age, body mass index, length of infertility and baseline hormone levels. The authors could not collect thyroid-stimulating hormone (TSH) levels for the whole group. Some women with abnormal levels may be included. The paper reports pregnancy, implantation and abortion rates but no live birth rate. The authors say the mechanism is unresolved and call their explanations speculation.

RRM Context

Restorative reproductive medicine looks for the cause of infertility before treatment starts. The authors cite earlier work that calls thyroid antibodies a marker of abnormal autoimmunity. The antibody-positive women here had no adjuvant treatment, such as steroids or blood thinners. IVF proceeds without finding why conception fails. The immune finding went unaddressed.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To investigate the impact of antithyroid antibody on pregnancy outcome following the in vitro fertilization and embryo transfer (IVF-ET).

Methods

A total of 90 patients (156 cycles) positive for antithyroid antibody (ATA+ group) and 676 infertile women (1062 cycles) negative for antithyroid antibody (ATA- group) undergoing IVF/ICSI from August 2009 to August 2010 were retrospectively analyzed.

Results

There was no significant difference in the days of ovarian stimulation, total gonadotropin dose, serum E2 level of HCG day and number of oocytes retrieved between the two groups. The fertilization rate, implantation rate and pregnancy rate following IVF-ET were significantly lower in women with antithyroid antibody than in control group (64.3% vs 74.6%, 17.8% vs 27.1% and 33.3% vs 46.7%, respectively), but the abortion rate was significantly higher in patients with antithyroid antibody (26.9% vs 11.8%).

Conclusion

Patients with antithyroid antibody showed significantly lower fertilization rate, implantation rate and pregnancy rate and higher risk for abortion following IVF-ET when compared with those without antithyroid antibody. Thus, the presence of antithyroid antibody is detrimental for the pregnancy outcome following IVF-ET.

Topics

By this author

Related research

Genetics and Immunology › Reproductive Immunology › Autoimmune Conditions and Fertility · Assisted Reproduction › Outcomes and Effectiveness › Outcomes by Diagnosis · Pregnancy › Preconception Care › Preconception Screening
Yi-ping Zhong, Ying Ying, Can-quan Zhou, Yan-wen Xu, Qiong Wang, Jie Li, Xiao-ting Shen, Hai-tao Wu
Y Zhong, Y Ying, C Zhou, Y Xu, Q Wang, J Li, X Shen, H Wu
PMID 22253557 22253557 DOI 10.7150/ijms.3467 10.7150/ijms.3467 Zhong et al. 2012, Zhong 2012

Keywords

Autoantibodies, Immunoglobulins, Thyroid-Stimulating

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