The Association Between Autoimmune Thyroid Diseases And Ovarian Reserve

BackgroundCurrent studies suggest that one or two anti-thyroid antibodies and/or hypothyroidism may affect ovarian reserve,but the association between autoimmune thyroid diseases(ATD)and ovarian reserve remains undetermined.ObjectiveTo explore the association between ovarian reserve and ATD.MethodsThis study is a retrospective cross-sectional study.Among the female patients who went to the Reproductive Hospital Affiliated to Shandong University from May 2014 to January 2021 for their first assisted pregnancy treatment,a total of 386 qualified patients were tested for anti-Mullerian hormone(AMH),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),thyroid peroxidase antibody(TPOAb),thyroid globulin antibody(TgAb)on the same day and eligible patients were enrolled after excluding known causes(iatrogenic,genetic,and other autoimmune diseases other than ATD)for reduced ovarian reserve.According to the lower limit of age-appropriate serum AMH,ovarian reserve was divided into low ovarian reserve(LOR)and normal ovarian reserve(NOR).The thyroid hormone levels,anti-thyroid antibody levels,the prevalence of hypothyroidism,the prevalence of ATD and the positive rate of anti-thyroid antibody between the two ovarian reserve groups at each age stage were analyzed at 5-year intervals.ResultsFor the whole study population,there was no significant difference in thyroid hormone levels,anti-thyroid antibody levels,the prevalence of hypothyroidism,ATD and anti-thyroid antibody positivity between the two ovarian reserve groups.There was also no statistical difference in the above indicators between the two ovarian reserve groups in the 21-25 years old group,26-30 years old group and 36-40 years old group.In 31-35 years old group,the levels of TgAb in LOR group was higher than that in NOR group[14.77(10.00-315.50)vs10.00(10.00-17.54),P<0.05].The prevalence of ATD,the positive rate of TPOAb and TgAb in the LOR group were 42.4%,33.3%and 33.3%,respectively,which were statistically different from those in the NOR group(21.1%,12.3%,17.5%,P<0.05).After adjusting the confounders with Binary Logistic regression,the results showed that the LOR group was still associated with higher rate of ATD,compared with the NOR group[OR:2.278;95%CI:1.166-6.620,P<0.05].ConclusionIn women of reproductive age 31-35 years,low ovarian reserve is associated with a higher prevalence of ATD.