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Łukaszuk K, Kunicki M, Kulwikowska P, Liss J, Pastuszek E, Jaszczołt M, Męczekalski B, Skowroński K. The impact of the presence of antithyroid antibodies on pregnancy outcome following intracytoplasmatic sperm injection-ICSI and embryo transfer in women with normal thyreotropine levels. J Endocrinol Invest 2015; 38:1335-43. [PMID: 26280321 DOI: 10.1007/s40618-015-0377-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of our study was to investigate the impact of anti-thyroid peroxidase antibodies (Anti-TPO) on pregnancy outcome following the in vitro fertilization and embryo transfer (IVF-ET) in general groups and in subgroups divided according to AMH level and age. METHODS A total of 114 patients positive for anti-thyroid peroxidase antibodies (Anti-TPO+ group) and 495 infertile women negative for anti-thyroid peroxidase antibodies (Anti-TPO- group) undergoing IVF with ICSI from April 2010 to April 2012 were analyzed retrospectively. RESULTS There were no significant differences in age, BMI, basal FSH, LH, AMH levels and duration of infertility between the two main groups. No significant differences in terms of the days of ovarian stimulation, estradiol level in day 8, total gonadotropin dose, number of oocytes retrieved, available embryos and blastocysts, number of embryos transferred nor in rates of fertilization, implantation, clinical pregnancy, live birth and abortion rate between two main groups were found. The only statistically significant difference among the groups with different anti-TPO antibodies levels was found in basal FSH concentration and BMI. Among the clinical outcomes of IVF with respect to the different anti-TPO levels, the only significant difference was found for the number of oocytes retrieved. Analysis of the baseline parameters in relationship to age categories and AMH levels found significant differences between women positive and negative for thyroid antibodies with respect to basal FSH and LH levels for women >37 years and for basal FSH in AMH <0.6 subgroup. CONCLUSIONS The present study reveals that patients with anti-TPO antibodies showed no significant differences in fertilization, implantation, pregnancy rates, live birth rates and no higher risk for miscarriage following IVF-ET when compared with those negative for anti-thyroid antibodies.
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Affiliation(s)
- K Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
- INVICTA Fertility and Reproductive Center, Gdańsk, Poland
- INVICTA Fertility and Reproductive Center, Invicta Złota 6 Str, 00019, Warsaw, Poland
| | - M Kunicki
- INVICTA Fertility and Reproductive Center, Invicta Złota 6 Str, 00019, Warsaw, Poland.
| | - P Kulwikowska
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | - J Liss
- INVICTA Fertility and Reproductive Center, Gdańsk, Poland
| | - E Pastuszek
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
- INVICTA Fertility and Reproductive Center, Gdańsk, Poland
| | - M Jaszczołt
- Department of Chemical and Process Engineering Chemical Faculty, Gdansk University of Technology, Gdańsk, Poland
| | - B Męczekalski
- Department of Gynecological Endocrinology, Poznan Univeristy of Medcial Sciences, Poznan, Poland
| | - K Skowroński
- Institute of Computer Science, Faculty of Mathematics, Physics and Informatics, University of Gdansk, Gdańsk, Poland
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Magri F, Schena L, Capelli V, Gaiti M, Zerbini F, Brambilla E, Rotondi M, De Amici M, Spinillo A, Nappi RE, Chiovato L. Anti-Mullerian hormone as a predictor of ovarian reserve in ART protocols: the hidden role of thyroid autoimmunity. Reprod Biol Endocrinol 2015; 13:106. [PMID: 26391773 PMCID: PMC4578365 DOI: 10.1186/s12958-015-0103-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 09/09/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Protocols of controlled ovarian hyper-stimulation (COH) require, as a crucial step, the identification of reliable predictors of ovarian reserve. Anti-Mullerian hormone (AMH) is one of the most reliable predictors of ovarian reserve but other factors including autoimmune thyroid diseases (ATD) have been associated with reduced fertility and poor COH outcome. Aim of the present study was to evaluate the relationship between ATD and AMH, and their role on the outcome of COH. METHODS The study group included 288 sub-fertile euthyroid women aged less than 40 years attending a single center for Reproductive Medicine. Among them, 55 were ATD-positive and 233 ATD-negative. The serum levels of AMH, FSH, LH, estradiol (E2), and TSH were measured before COH. The ratio between serum E2 concentration on the day of oocytes pick-up and the total dose of administered recombinant FSH (r-FSH) (E2/r-FSH ratio) was calculated. RESULTS The serum levels of AMH were significantly related to E2/r-FSH ratio, total dose of r-FSH and number of M II oocytes, both in ATD-positive and ATD-negative women. Within the low stratum of AMH levels, the presence of ATD did not further affect the outcome of COH. When the serum levels of AMH were in the high stratum, the presence of ATD significantly affected the E2/rFSH ratio, the total dose of r-FSH and the number of M II oocytes. CONCLUSIONS The probability of a poor response to COH is high, and independent from ATD, in women with low AMH serum levels. In women with a good ovarian reserve, as assessed by high AMH serum levels, the presence of ATD impairs the outcome of COH.
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Affiliation(s)
- Flavia Magri
- Unit of Internal Medicine and Endocrinology, IRCCS Foundation S. Maugeri, University of Pavia, via S.Maugeri 10, 27100, Pavia, Italy.
| | - Lucia Schena
- Unit of Internal Medicine and Endocrinology, IRCCS Foundation S. Maugeri, University of Pavia, via S.Maugeri 10, 27100, Pavia, Italy.
| | - Valentina Capelli
- Unit of Internal Medicine and Endocrinology, IRCCS Foundation S. Maugeri, University of Pavia, via S.Maugeri 10, 27100, Pavia, Italy.
| | - Margherita Gaiti
- Unit of Internal Medicine and Endocrinology, IRCCS Foundation S. Maugeri, University of Pavia, via S.Maugeri 10, 27100, Pavia, Italy.
| | - Francesca Zerbini
- Unit of Internal Medicine and Endocrinology, IRCCS Foundation S. Maugeri, University of Pavia, via S.Maugeri 10, 27100, Pavia, Italy.
| | - Emanuela Brambilla
- Research Center for Reproductive Medicine, Unit of Obstetrics and Gynecology, IRCCS S. Matteo Foundation, University of Pavia, Pavia, Italy.
| | - Mario Rotondi
- Unit of Internal Medicine and Endocrinology, IRCCS Foundation S. Maugeri, University of Pavia, via S.Maugeri 10, 27100, Pavia, Italy.
| | - Mara De Amici
- Department of Pediatrics, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy.
| | - Arsenio Spinillo
- Research Center for Reproductive Medicine, Unit of Obstetrics and Gynecology, IRCCS S. Matteo Foundation, University of Pavia, Pavia, Italy.
| | - Rossella E Nappi
- Research Center for Reproductive Medicine, Unit of Obstetrics and Gynecology, IRCCS S. Matteo Foundation, University of Pavia, Pavia, Italy.
| | - Luca Chiovato
- Unit of Internal Medicine and Endocrinology, IRCCS Foundation S. Maugeri, University of Pavia, via S.Maugeri 10, 27100, Pavia, Italy.
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