The impact of thyroid function and thyroid autoimmunity on embryo quality in women with low functional ovarian reserve: a case-control study

Reproductive Biology and Endocrinology

Norbert Gleicher¹  David H. Barad¹  Vitaly A. Kushnir³  Eric Himaya²  Andrea Weghofer³ 

[1] The Foundation for Reproductive Medicine, 69th street, New York 10021, NY, USA;Department of Obstetrics and Gynecology, Hospitalier de l’Université de Montréal, 2065, Rue Alexandre-de Sève, Montréal, Canada;The Center for Human Reproduction, 21E 69th street, New York 10021, NY, USA

关键词: Thyroid Stimulating Hormone (TSH);    Thyroid autoimmunity;    Low Functional Ovarian Reserve (LFOR);    In Vitro Fertilization (IVF);    Euthyroid;    Embryo quality;    Diminished Ovarian Reserve (DOR);   

Others  :  1216421
DOI  :  10.1186/s12958-015-0041-0

 received in 2014-12-31, accepted in 2015-05-07,  发布年份 2015

【 摘 要 】

Background

Women with hyper-and hypothyroidism are at increased risk for infertility and adverse pregnancy outcomes. Whether in women considered euthyroid thyroid function (TSH values) and thyroid autoimmunity (thyroid antibodies) influence in vitro fertilization (IVF) cycle outcome has, however, remained controversial. Any such effect should be easily visible in women with low functional ovarian reserve (LFOR) and thus small oocyte and embryo numbers.

Methods

We evaluated the relationship between TSH levels and embryo quality in euthyroid women with LFOR undergoing IVF. Mean age for the study population was 39.9 ± 4.6 years. Embryo quality was assessed in 431 embryos from 98 first IVF cycles according to TSH levels (with cut-off 2.5μIU/mL), and to presence versus absence of thyroid autoantibodies.

Results

Mean Anti Mullerian hormone (AMH) was 0.8 ± 0.8 ng/mL and mean TSH was 1.8 ± 0.9 μIU/mL. Comparable embryo quality was observed in women with TSH ≤ and >2.5μIU/mL. TPO antibodies significantly affected embryo quality in women with low-normal TSH levels (P = 0.045). In women with high-normal TSH levels, increasing TSH had a negative impact on embryo quality (P = 0.027). A trend towards impaired embryo quality with TPO antibodies was also observed in these patients (p = 0.057).

Conclusions

TPO antibodies affect embryo quality in euthyroid women with low-normal TSH ≤2.5 μIU/mL. In women with high-normal TSH levels, increasing TSH levels, and possibly TPO antibodies, appear to impair embryo quality. These results suggest that the negative impact of thyroid autoimmunity becomes apparent, once thyroid hormone function is optimized.

【 授权许可】

   
2015 Weghofer et al.; licensee BioMed Central.

【 图 表 】

Fig. 1.

Figure 1.

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