Relationship Between TPO-Ab And TSH With In Vitro Fertilization And Embryo Transfer

Background Background Thyroid gland produces thyroid function in the body’s various tissues and organs. When abnormal thyroid function affects fertility.Autoimmune Thyroid Diseases(AITD) organ specific autoimmune disease is mediated by T cells. Iconic thyroid autoantibodies of AITD is thyroid peroxidase antibodies(TPO-Ab).In recent years about thyroid autoantibodies (ATA) for in vitro fertilization and embryo transfer(IVF-ET) assisted association study is limited, the influence of the research indicates that ATA in IVF-ET assisted reproduction can produce adverse effect.But the results are not clear until today. In2011the American thyroid association of pregnancy and postpartum thyroid disease diagnosis and management guidelines recommend that it has good effects on pregnancy when thyroid stimulating hormone (TSH)<2.5uIU/mL. Therefore this study is to accept IVF-ET in my center of assisted reproduction in patients with thyroid autoantibodies positive TPO-Ab and TSH for each key link in the whole process of assisted reproduction treatment of correlation study. For the future of IVF-ET that is assisted reproduction of TPO-Ab positive patients implement effective clinical intervention, intervention direction and research basis for intervention time is determined. Thus reducing for TPO-Ab positive results in IVF-ET in patients with the occurrence of adverse clinical outcomes.Objective Study of thyroid peroxidase antibodies and thyroid stimulating effect on in vitro fertilization embryo transfer ending.Methods From March2011to October2013in the reproductive center in Qinghai province people’s hospital in vitro fertilization embryo transfer a total of378cycles were retrospectively analyzed.1. Basis for TPO-Ab grouping:Research group is thyroid peroxidase antibody positive and thyroid function in patients with normal69cycles (TPO-Ab+group), control group is thyroid peroxidase antibody negative and thyroid function in patients with normal309cycles (TPO-Ab group).2. Basis for TPO-Ab+and TSH grouping:Research group is thyroid peroxidase antibody positive and thyroid stimulating hormone<2.5uiu/mL patients31cycles (TPO-Ab+&TSH <2.5group), control group is thyroid peroxidase antibody positive and thyroid stimulating hormone≥2.5uiu/mL patients38cycles (TPO-Ab+&TSH≥2.5group).3. Basis for TPO-Ab-and TSH grouping:Research group is thyroid peroxidase antibody negative and thyroid stimulating hormone<2.5uiu/mL patients115cycles (TPO-Ab-&TSH <2.5group), control group is thyroid peroxidase antibody negative and thyroid stimulating hormone>2.5uiu/mL patients194cycles (TPO-Ab-&TSH>2.5group).Results:1.TPO-Ab group results:There was no statistical difference between research group and control group with the general information, super ovulation scheme, the number of eggs, super ovulation, portable intrauterine embryo number, embryo transfer number, transplantation days membrane thickness, TSH, T3, T4and pregnancy rate. IVF fertility rate between the two groups is79.76%and79.76%respectively, high quality embryo rate (46.59%,54.49%) TPO-Ab+group was lower than that in group TPO-Ab-, the difference was statistically significant (P<0.05); Abortion rate (33.33%) of TPO-Ab+group was obviously higher than that of TPO-Ab-control group (16.11%), the difference was statistically significant (P<0.05).2.TPO-Ab+grouping and TSH results:There was no statistical difference between research group and control group with the general information, super ovulation scheme, the number of eggs, super ovulation, fertilization rate, portable embryo number, number of embryo transfer, transfer day intrauterine membrane thickness, T3, pregnancy rate, miscarriage rate, but the TPO-Ab+&TSH<2.5groups of abortion rate (18.75%) is lower than the TPO-Ab+&TSH≥2.5group (47.06%), high quality embryo rate between the two groups (55.39%, 40.32%) TPO-Ab+&TSH<2.5groups significantly higher than the TPO-Ab+&TSH>2.5groups, the difference was statistically significant (P<0.05), T4value between the two groups (15.76±2.00mm,14.27±2.04) TPO-Ab+&TSH<2.5group is significantly higher than the TPO-Ab+&TSH>2.5group, and the difference was statistically significant (P<0.05).3.TPO-Ab-grouping and TSH results:There was no statistical difference between research group and control group with the general information, super ovulation scheme, the number of eggs, super ovulation, fertilization rate, portable embryos for several days, the number of embryos, the transplantation intrauterine membrane thickness. T3, T4, pregnancy rate, miscarriage rate. High quality embryo rate between the two groups (58.19%,52.19%) TPO-Ab-&TSH<2.5group is significantly higher than the TPO-Ab-&TSH>2.5group, the difference was statistically significant (P<0.05).Conclusion Thyroid peroxidase antibody positive and high thyroid stimulating hormone have negative effects on IVF-ET ending, for TPO-Ab positive and TSH acuity2.5uiu/mL before receiving IVF-ET in patients with thyroid function should be adjusted to IVF-ET.