Use of assisted reproductive technologies in euthyroid women with antibodies to the thyroid gland. A literature review

Cover Page
Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract


The presence of antibodies to thyroid peroxidase and thyroglobulin of the thyroid gland in women with infertility is more common than in the population. Some studies describe the negative effect of autoantibodies on reproductive function and the results of assisted reproductive technology (ART) programs even in the absence of impaired thyroid function. This article presents a review of literature data on the possible mechanisms of this negative influence. To date, there are no data on a significant decrease in the quality of oocytes, embryos and pregnancy rates in ART cycles in such patients. The negative effect of autoantibodies on the frequency of live births can be realized through such complications of pregnancy as miscarriage and premature birth. Currently, the possibilities for preventing these complications are poorly understood. According to recent meta-analyses, the use of levothyroxine in euthyroid patients with autoantibodies who are treated for infertility using ART methods does not result in a decrease in the frequency of miscarriage and premature birth.


Full Text

Restricted Access

About the authors

Inga V. Gorelova

V.A. Almazov National Medical Research Center

Author for correspondence.
Email: ivmosyagina@gmail.com
ORCID iD: 0000-0002-6098-1491
SPIN-code: 1207-5705

Russian Federation, Saint-Petersburg

PhD, Head of the Research Laboratory of Reproductive Technologies

Ksenia A. Prikhodko

V.A. Almazov National Medical Research Center

Email: kseniyaprihodko@yandex.ru

Russian Federation, Saint-Petersburg

resident 2 years of training 

Maxim V. Rulev

V.A. Almazov National Medical Research Center

Email: maxrul@mail.ru
ORCID iD: 0000-0002-7906-4634
SPIN-code: 2001-0577

Russian Federation, Saint-Petersburg

PhD, Head of the Department of Assisted Reproductive Technologies

Irina E. Zazerskaya

V.A. Almazov National Medical Research Center

Email: zazera@mail.ru
ORCID iD: 0000-0003-4431-3917
SPIN-code: 5683-6741

Russian Federation, Saint-Petersburg

MD, PhD, Head of the Department of Obstetrics and Gynecology

References

  1. Busnelli A, Paffoni A, Fedele L, Somigliana E. The impact of thyroid autoimmunity on IVF/ICSI outcome: A systematic review and meta-analysis. Hum Reprod Update. 2016;22(6):775-790. https://doi.org/10.1093/humupd/dmw019.
  2. Poppe K, Velkeniers B, Glinoer D. Thyroid disease and female reproduction. Clin Endocrinol (Oxf). 2007;66(3):309-321. https://doi.org/10.1111/j.1365-2265.2007.02752.x.
  3. Monteleone P, Parrini D, Faviana P, et al. Female infertility related to thyroid autoimmunity: The ovarian follicle hypothesis. Am J Reprod Immunol. 2011;66(2):108-114. https://doi.org/10.1111/j.1600-0897.2010.00961.x
  4. Miko E, Meggyes M, Doba K, et al. Characteristics of peripheral blood NK and NKT-like cells in euthyroid and subclinical hypothyroid women with thyroid autoimmunity experiencing reproductive failure. J Reprod Immunol. 2017;124:62-70. https://doi.org/10.1016/j.jri.2017.09.008.
  5. Cho MK. Thyroid dysfunction and subfertility. Clin Exp Reprod Med. 2015;42(4):131-135. https://doi.org/10.5653/cerm.2015.42.4.131.
  6. Poppe K, Velkeniers B, Glinoer D. The role of thyroid autoimmunity in fertility and pregnancy. Nat Clin Pract Endocrinol Metab. 2008;4(7):394-405. https://doi.org/10.1038/ncpendmet0846.
  7. Ибрагимова М.Х. Оптимизация тактики ведения ранних сроков индуцированной беременности с учетом функционального состояния щитовидной железы // АГ-Инфо (журнал Российской ассоциации акушеров-гинекологов). − 2009. − № 3. − С. 30–35. [Ibragimova MH. Optimizatsiya taktiki vedeniya rannikh srokov indutsirovannoy beremennosti s uchetom funktsional’nogo sostoyaniya shchitovidnoy zhelezy. AG-Info (Zhurnal Rossiyskoy assotsiatsii akusherov-ginekologov). 2009;(3):30-35. (In Russ.)]
  8. Thangaratinam S, Tan A, Knox E, et al. Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ. 2011;342:d2616. https://doi.org/10.1136/bmj.d2616.
  9. Toulis KA, Goulis DG, Venetis CA, et al. Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing IVF: A meta-analysis. Eur J Endocrinol. 2010;162(4):643-652. https://doi.org/10.1530/EJE-09-0850.
  10. Unuane D, Velkeniers B, Deridder S, et al. Impact of thyroid autoimmunity on cumulative delivery rates in vitro fertilization/intracytoplasmic sperm injection patients. Fertil Steril. 2016;106(1):144-150. https://doi.org/10.1016/ j.fertnstert.2016.03.011.
  11. Leiva P, Schwarze JE, Vasquez P, et al. There is no association between the presence of anti-thyroid antibodies and increased reproductive loss in pregnant women after ART: A systematic review and meta-analysis. JBRA Assist Reprod. 2017;21(4):361-365. https://doi.org/10.5935/1518-0557.20170057.
  12. Akhtar MA, Agrawal R, Brown J, et al. Thyroxine replacement for subfertile women with euthyroid autoimmune thyroid disease or subclinical hypothyroidism. Cochrane Database Syst Rev. 2019;6(6):CD011009. https://doi.org/ 10.1002/14651858.CD011009.pub2.
  13. Rao M, Zeng Z, Zhou F, et al. Effect of levothyroxine supplementation on pregnancy loss and preterm birth in women with subclinical hypothyroidism and thyroid autoimmunity: A systematic review and meta-analysis. Hum Reprod Update. 2019;25(3):344-361. https://doi.org/10.1093/humupd/dmz003.
  14. Revelli A, Casano S, Piane LD, et al. A retrospective study on IVF outcome in euthyroid patients with anti-thyroid antibodies: Effects of levothyroxine, acetyl-salicylic acid and prednisolone adjuvant treatments. Reprod Biol Endocrinol. 2009;7:137. https://doi.org/10.1186/1477-7827-7-137.
  15. Revelli A, Dolfin E, Gennarelli G, et al. Low-dose acetylsalicylic acid plus prednisolone as an adjuvant treatment in IVF: A prospective, randomized study. Fertil Steril. 2008;90(5):1685-1691. https://doi.org/10.1016/j.fertnstert.2007.08.037.
  16. Litwicka K, Arrivi C, Varricchio MT, et al. In women with thyroid autoimmunity, does low-dose prednisolone administration, compared with no adjuvant therapy, improve in vitro fertilization clinical results? J Obstet Gynaecol Res. 2015;41(5):722-728. https://doi.org/10.1111/jog.12615.

Supplementary files

There are no supplementary files to display.

Statistics

Views

Abstract - 29

PDF (Russian) - 10

PDF (English) - 0

Cited-By


Article Metrics

Metrics Loading ...

PlumX

Dimensions


Copyright (c) 2020 Gorelova I.V., Prikhodko K.A., Rulev M.V., Zazerskaya I.E.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies