| BackgroundThe anti-thyroid autoantibodies(ATA)are the signature antibodies of the autoimmune thyroid disease(AITD),The thyroid peroxidase antibodies(TPOAb)and thyroglobulin antibody(TgAb)are widely used in clinic.Thyroid is closely related to female reproductive system,and thyroid dysfunction significantly affects female fertility.Thyroid autoimmunity(TAI),characterized by positive ATA,is thought to be the main cause of hypothyroidism.The effect of ATA positive with normal thyroid function on assisted reproductive technology(ART)is still controversial.Previous studies have found that the ATA rate was higher in polycystic ovarian syndrome(PCOS)than in the general population.PCOS is one of the most common gynecological endocrine diseases in women of childbearing age.Its clinical characteristics are mainly clinical and/or biochemical manifestations of hyperandrogen,thin ovulation or anovulation,and polycystic ovarian changes.PCOS seriously affects the reproductive health of women and can cause infertility.They need to rely on lifestyle improvement,ovulation induction and other means to achieve reproductive purpose.Some PCOS patients even need to use ART to achieve reproductive desire,and whether ATA has an effect on ART outcome of PCOS patients remains unclear.ObjectiveTo analyze the effect of ATA positive on the pregnancy outcomes as well as maternal and fetal complications of PCOS who undergoing frozen embryo transfer(FET)after IVF/ICSI.MethodsWomen with PCOS who had their first FET after the first cycle of IVF/ICSI in Hospital for Reproductive Medicine Affiliated to Shandong University from June 2019 to October 2022 were retrospectively enrolled.PCOS patients with normal thyroid function and ATA positive were enrolled in the study group(ATA positive group),while PCOS patients with normal thyroid function and ATA negative were enrolled in the control group(ATA negative group).The pregnancy outcomes as well as maternal and infant complications of the two groups were compared,including clinical pregnancy rate,early abortion rate,premature birth rate,macrosomia,low birth weight infants,etc.ATA positive group was divided into two groups according to the thyroid stimulating hormone(TSH)levels.The range of normal low TSH level group was 0.27uIU/mL<TSH<2.5uIU/mL,normal high TSH level group range is 2.5uIU/mL≤TSH<4.2 uIU/mL,subgroup analysis was performed for the two subgroups in the ATA positive group.ResultsThis study included 276 women with PCOS,including 60 in the ATA positive group and 216 in the ATA negative group.There was no statistical difference in biochemical pregnancy rate,clinical pregnancy rate and live birth rate between the two groups,but the early abortion rate in ATA positive group was signi ficantly higher than that in ATA negative group(32.43%vs 12.10%,P=0.004).There was no significant difference in maternal and fetal complications between ATA positive group and ATA negative group,including premature delivery,gestational diabetes mellitus(GDM)and macrosomia.Subgroup analysis of ATA positive group showed that TSH level in normal range had no significant effect on pregnancy outcomes.ConclusionPositive Anti-thyroid autoantibodies TgAb and/or TPOAb increased the risk of early abortion in IVF/ICSI in women with PCOS,and had no significant effect on other pregnancy outcomes or maternal and infant complications.In the case of TgAb and/or TPOAb positive,TSH levels in the normal range had no effect on pregnancy outcomes... |
