■这项研究的目的是评估甲状腺自身免疫(TAI)与获取的卵母细胞数(NOR)的关联,受精率(FR),甲状腺功能正常的不孕和卵巢储备(DOR)减少的女性的胚胎质量(EQ)。
■这项回顾性队列研究涉及1,172名年龄在20-40岁的甲状腺功能正常的女性,患有不孕症和DOR,他们经历了一个取卵周期。在血清甲状腺过氧化物酶抗体(TPOAb)浓度高于34IU/ml和/或血清甲状腺球蛋白抗体(TgAb)浓度超过115.0IU/ml的情况下诊断为TAI。在这些女性中,147例TAI患者被归类为TAI阳性组,而1,025例无TAI的患者被归类为TAI阴性组。使用针对混杂因素进行调整的广义线性模型(GLM),我们评估了TAI与血清TPOAb和TgAb浓度和NOR的关系,FR,和EQ在这项研究的主题。对TPOAb和TGAb值进行log10转化以减少偏度。使用Logistic回归模型来估计TPOAb和TgAb浓度对实现高NOR(≥7)和高FR(>60%)的概率的影响。
■对于整个研究人群,与没有TAI的女性相比,患有TAI的女性的NOR和EQ显著降低(两者均P<0.001).有趣的是,在TSH≤2.5亚组中,与TAI阴性组相比,TAI阳性组的NOR和EQ也显著降低(两者均P<0.001).此外,在log10(TPOAb)浓度和NOR与优质胚胎和可用胚胎数量之间观察到负相关(全部P<0.05).log10(TgAb)浓度与NOR和高质量胚胎数量呈负相关(均P<0.05)。在回归分析中,log10(TPOAb)浓度达到高NOR的概率较低[校正比值比(aOR):0.56;95%置信区间(95%CI)0.37,0.85;P=0.007].
■TAI和较高的TPOAb和TgAb浓度显示与研究人群中NOR和EQ的降低相关。我们的发现提供了进一步的证据,以支持甲状腺功能正常的不孕和DOR女性TAI的系统筛查和治疗。
UNASSIGNED: The aim of this study was to evaluate the associations of thyroid autoimmunity (TAI) with the number of oocytes retrieved (NOR), fertilization rate (FR), and embryo quality (EQ) in euthyroid women with infertility and diminished ovarian reserve (DOR).
UNASSIGNED: This retrospective cohort study involved 1,172 euthyroid women aged 20-40 years with infertility and DOR who underwent an oocyte retrieval cycle. TAI was diagnosed in the presence of serum thyroperoxidase antibody (TPOAb) concentrations higher than 34 IU/ml and/or serum thyroglobulin antibody (TgAb) concentrations exceeding 115.0 IU/ml. Among these women, 147 patients with TAI were classified as the TAI-positive group, while 1,025 patients without TAI were classified as the TAI-negative group. Using generalized linear models (GLMs) adjusted for confounding factors, we evaluated the associations of TAI and the serum TPOAb and TgAb concentrations and NOR, FR, and EQ in this study\'s subjects. The TPOAb and TGAb values were subjected to log10 transformation to reduce skewness. Logistic regression models were used to estimate the effects of TPOAb and TgAb concentrations on the probabilities of achieving a high NOR (≥7) and high FR (>60%).
UNASSIGNED: For the whole study population, women with TAI had a significantly lower NOR and poorer EQ than women without TAI (P < 0.001 for both). Interestingly, in the TSH ≤2.5 subgroup, the TAI-positive group also had a significantly lower NOR and poorer EQ than the TAI-negative group (P < 0.001 for both). Furthermore, negative associations were observed between log10(TPOAb) concentrations and NOR and the number of high-quality embryos and available embryos (P < 0.05 for all). The log10(TgAb) concentrations were inversely associated with NOR and the number of high-quality embryos (P < 0.05 for all). In the regression analysis, the log10(TPOAb) concentrations had lower probabilities of achieving a high NOR [adjusted odds ratio (aOR): 0.56; 95% confidence interval (95% CI) 0.37, 0.85; P = 0.007].
UNASSIGNED: TAI and higher TPOAb and TgAb concentrations were shown to be associated with reductions in the NOR and EQ in the study population. Our findings provide further evidence to support systematic screening and treatment for TAI in euthyroid women with infertility and DOR.