METHODS: The data of 721 infertile patients who visited the hospital from January 2019 to September 2022 and whose thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels were in the normal range, were retrospectively analyzed. These patients were divided into two sets of three groups-the negative group, the 2.6 IU/ml ~ 100 IU/ml group and the TPOAb > 100 IU/ml group according to the TPOAb (thyroid peroxidase antibody) level, or the TgAb (anti-thyroglobulin antibody) negative group, the 14.58 IU/ml ~ 100 IU/ml group and the TgAb > 100 IU/ml group according to the TgAb level. They were compared for differences in ovarian reserve function index and thyroid hormone levels and analyzed for the relationship among thyroid antibody levels, ovarian reserve function, and thyroid hormone levels.
RESULTS: When TSH > 2.5 mIU/L, the bFSH (basal follicle stimulating hormone) level in the TPOAb > 100 IU/ml group (9.10 ± 1.16 IU/L) was significantly higher than that in the TPOAb negative group (8.12 ± 1.97 IU/L) and the 2.6 IU/ml ~ 100 IU/ml group (7.90 ± 1.48 IU/L) (P < 0.05); when TSH ≤ 2.5 mIU/L, there were no statistically significant differences in the bFSH and AFC (antral follicle count) number at different TPOAb levels. Whether TSH ≤ 2.5 mIU/L or TSH > 2.5 mIU/L, there were no statistically significant differences in the bFSH and AFC number at different TgAb levels (P > 0.05). FT3/FT4 ratio in the TPOAb 2.6 IU/ml ~ 100 IU/ml group and the > 100 IU/ml group was significantly lower than in the negative group. FT3/FT4 ratio in the TgAb 14.58 ~ 100 IU/ml group and the > 100 IU/ml group was also significantly lower than in the TgAb negative group (P < 0.05). TSH level in the TPOAb > 100 IU/ml group was significantly higher than in the 2.6 ~ 100 IU/ml group and the TPOAb negative group, but there were no statistically significant differences among different TgAb groups.
CONCLUSIONS: When TPOAb > 100 IU/ml and TSH > 2.5 mIU/L, it may affect the ovarian reserve function in infertile patients, and the mechanism may be associated with increased TSH and the imbalance of FT3/FT4 ratio caused by the increase of TPOAb.
方法:2019年1月至2022年9月就诊的721例不育患者的数据,其甲状腺刺激激素(TSH),游离三碘甲状腺原氨酸(FT3),游离甲状腺素(FT4)水平在正常范围内,进行回顾性分析。这些患者被分为两组三组-阴性组,根据TPOAb(甲状腺过氧化物酶抗体)水平,2.6IU/ml〜100IU/ml组和TPOAb>100IU/ml组,或TgAb(抗甲状腺球蛋白抗体)阴性组,根据TgAb水平,14.58IU/ml〜100IU/ml组和TgAb>100IU/ml组。比较卵巢储备功能指标和甲状腺激素水平的差异,分析甲状腺抗体水平与卵巢储备功能,甲状腺激素水平.
结果:当TSH>2.5mIU/L时,TPOAb>100IU/ml组的bFSH(基础卵泡刺激素)水平(9.10±1.16IU/L)明显高于TPOAb阴性组(8.12±1.97IU/L)和2.6IU/ml〜100IU/ml组(7.90±1.48IU/L)(P<0.05);当TSH≤2.5mIU/L时,在不同的TPOAb水平下,bFSH和AFC(窦卵泡计数)数量无统计学差异。TSH≤2.5mIU/L或TSH>2.5mIU/L,不同TgAb水平的bFSH和AFC数量差异无统计学意义(P>0.05)。TPOAb2.6IU/ml~100IU/ml组和>100IU/ml组的FT3/FT4比值显著低于阴性组。TgAb14.58~100IU/ml组和>100IU/ml组的FT3/FT4比值也显著低于TgAb阴性组(P<0.05)。TPOAb>100IU/ml组的TSH程度明显高于2.6~100IU/ml组和TPOAb阴性组,但不同TgAb组间差异无统计学意义。
结论:当TPOAb>100IU/ml和TSH>2.5mIU/L时,它可能会影响不孕患者的卵巢储备功能,其机制可能与TSH升高及TPOAb升高引起的FT3/FT4比值失衡有关。