Autoimunost štitnjače i ishodi IVF/ICSI kod eutireoidnih žena: sistematski pregled i meta-analiza.
Reproductive biology and endocrinology : RB&E
Sažetak istraživanja
Pozadina Autoimunost štitne žlezde (TAI) – prisustvo antitireoidne peroksidaze i/ili antitireoglobulinskih antitela – pogađa 8-14% žena u reproduktivnoj dobi. Žestoka je debata da li TAI negativno utiče na ishode IVF/ICSI. Ovaj sistematski pregled i meta-analiza procijenili su odnos između autoimunosti štitnjače (TAI) i ishoda IVF/ICSI, kako u cjelini, tako i među eutireoidnim ženama poznate dobi koristeći stroge kriterije za grupisanje ishoda trudnoće.
Metode Recenzija je registrovana kod PROSPERO: CRD42019120947. Pretrage su sprovedene u MEDLINE, EMBASE, Web of Science i Cochrane bazi podataka od početka do marta 2020. Primarni ishodi bili su klinička stopa trudnoće, klinička stopa pobačaja, biohemijski gubitak trudnoće, stopa živorođenja po ciklusu i stopa živorođenih po kliničkoj trudnoći (CP).
Rezultati U metaanalizu je uključeno 14 studija. U poređenju sa ženama koje su bile negativne na autoantitijela na štitnjaču (TAI-), nije bilo značajne razlike u ukupnoj kliničkoj stopi trudnoće (OR 0,86; 95%CI [0,70, 1,05]; P = 0,14; 11 studija; I 2 = 29,0%), ili kod eutireoidnih žena (OR 0,16%; 0,19%CI; 0,19%CI; = 0,29 10 studija; Takođe nije bilo značajne razlike u ukupnoj kliničkoj stopi pobačaja (OR 1,04; 95% CI [0,52, 2,07]; P = 0,908; 8 studija; I 2 = 53%) ili kod eutireoidnih žena (OR 1,18; 95% CI [0,52, 2,64]; 6 P = 2,64]; 6 P = 2,64; Nije bilo značajne razlike u biohemijskom gubitku trudnoće (OR 1,14; 95% CI [0,48, 2,72]; P = 0,769; 4 studije; I2 = 0,0%), stopi živorođenih po ciklusu (OR 0,84; 95% CI [0,67, 1,06]; P = 0,25 stopa po kliničkoj trudnoći; I = 0,25 stopa po trudnoći. 0,67% CI [0,28, 1,60] P = 0,369 I 2 = 69,2%), kako sveukupno, tako i kod eutireoidnih žena; Takođe nije bilo značajne razlike u broju prenesenih embriona, broju izvađenih jajnih ćelija, srednjoj starosti majke ili ukupnim nivoima TSH ili kod eutireoidnih žena.
Zaključak Nalazi ove studije sugeriraju da autoimunost štitnjače nema utjecaja na ishod trudnoće samo kod eutireoidnih žena, ili kod eutireoidnih žena i žena sa subkliničkim hipotireoidizmom.
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Thyroid autoimmunity and IVF/ICSI outcomes in euthyroid women: a systematic review and meta-analysis.
Background Thyroid autoimmunity (TAI) - the presence of anti-thyroid peroxidase and/or anti-thyroglobulin antibodies - affects 8-14% of reproductively-aged women. It is hotly debated whether TAI adversely affects IVF/ICSI outcomes. This systematic review and meta-analysis evaluated the relationship between thyroid autoimmunity (TAI) and IVF/ICSI outcomes, both overall and amongst euthyroid women of known age using strict criteria for grouping pregnancy outcomes.
Methods The review was registered with PROSPERO: CRD42019120947. Searches were undertaken in MEDLINE, EMBASE, Web of Science and Cochrane Database from Inception-March 2020. Primary outcomes were clinical pregnancy rate, clinical miscarriage rate, biochemical pregnancy loss, livebirth rate per-cycle and live birth rate per clinical pregnancy (CP).
Results 14 studies were included in the meta-analysis. Compared with women who tested negative for thyroid autoantibodies (TAI-), there was no significant difference in clinical pregnancy rate overall (OR 0.86; 95%CI [0.70, 1.05]; P = 0.14; 11 studies; I 2 = 29.0%), or in euthyroid women (OR 0.88; 95%CI [0.69, 1.12]; P = 0.29; 10 studies; I 2 = 32.0%). There was also no significant difference in clinical miscarriage rate overall (OR 1.04; 95%CI [0.52, 2.07]; P = 0.908; 8 studies; I 2 = 53%), or in euthyroid women (OR 1.18; 95%CI [0.52, 2.64]; P = 0.69; 7 studies; I 2 = 54%). There was no significant difference in biochemical pregnancy loss (OR 1.14; 95%CI [0.48, 2.72]; P = 0.769; 4 studies; I2 = 0.0%), live birth rate per cycle (OR 0.84; 95%CI [0.67, 1.06]; P = 0.145; I 2 = 1.7%), live birth rate per clinical pregnancy (OR 0.67; 95%CI [0.28, 1.60]; P = 0.369; I 2 = 69.2%), both overall and in euthyroid women as all studies included consisted of euthyroid women only. There was also no significant difference in number of embryos transferred, number of oocytes retrieved, mean maternal age or TSH levels overall or in euthyroid women.
Conclusion The findings of the present study suggest that thyroid autoimmunity has no effect on pregnancy outcomes in euthyroid women alone, or in euthyroid women and women with subclinical hypothyroidism.
Izvorni podaci
- DOI
- 10.1186/s12958-020-00671-3
- PMID
- 33239046
- PMCID
- PMC7687721
- Provjereno
- 2026-07-26
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