Dataset Information

Impact of Thyroid Autoimmunity in euthyroid women on the outcomes of In Vitro Fertilization.

ABSTRACT:

Objective

Infertility is inadequately acknowledged as a problem in developing countries. Thyroid Autoimmunity (TAI) has been neatly investigated for its association with unfavorable pregnancy and reproductive consequences. We aim to evaluate Clinical Pregnancy Rate (CPR) as a primary outcome following In Vitro Fertilization/Intra Cytoplasmic Sperm Injection (IVF/ICSI) in women with Thyroid Autoimmunity (TAI).

Methods

A Retrospective cohort study included 584 women who underwent IVF/ICSI treatment between November 2012 and April 2017 in Orient Hospital, Damascus, Syria. Patients were tested for TAI before IVF/ICSI procedure.

Results

CPR did not significantly differ between TAI positive and TAI negative groups (p > 0.05). Subgroup analysis for only primary infertility patients showed a statistically significant difference in CPR between TAI positive and TAI negative groups.

Conclusion

Although several arguments were in favor of the relation between IVF/ICSI outcomes and Thyroid autoimmune disease, the presence of TAI positivity did not adversely affect the clinical pregnancy rate.

SUBMITTER: Hamad A

PROVIDER: S-EPMC8214029 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Publications

Impact of Thyroid Autoimmunity in euthyroid women on the outcomes of In Vitro Fertilization.

Hamad Ahed A Alhalabi Nawras N Nmr Nazht N Abbas Fatima F Al-Hammami Hisham H Ibrahim Nazir N Alhalabi Marwan M

Annals of medicine and surgery (2012) 20210608

<h4>Objective</h4>Infertility is inadequately acknowledged as a problem in developing countries. Thyroid Autoimmunity (TAI) has been neatly investigated for its association with unfavorable pregnancy and reproductive consequences. We aim to evaluate Clinical Pregnancy Rate (CPR) as a primary outcome following In Vitro Fertilization/Intra Cytoplasmic Sperm Injection (IVF/ICSI) in women with Thyroid Autoimmunity (TAI).<h4>Methods</h4>A Retrospective cohort study included 584 women who underwent IV ...[more]

PMID: 34178319

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Project description:BackgroundThyroid 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.MethodsThe 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).Results14 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; I2 = 29.0%), or in euthyroid women (OR 0.88; 95%CI [0.69, 1.12]; P = 0.29; 10 studies; I2 = 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; I2 = 53%), or in euthyroid women (OR 1.18; 95%CI [0.52, 2.64]; P = 0.69; 7 studies; I2 = 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; I2 = 1.7%), live birth rate per clinical pregnancy (OR 0.67; 95%CI [0.28, 1.60]; P = 0.369; I2 = 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.ConclusionThe 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.

Project description:Background: At present, only one systematic review has investigated the effect of levothyroxine (LT4) in the treatment of euthyroid pregnant women with thyroid autoimmunity, but some problems [such as merging different types of research for meta-analysis, lacking neonatal outcomes, and so on] exist in this study, satisfactory results can not be provided. So, this systematic review was performed to investigate the effect of LT4 in euthyroid pregnant women with thyroid autoimmunity, in the hope of providing more comprehensive evidence for clinical use. Methods: Medline (Ovid), Embase (Ovid), and Cochrane Central Register of Controlled Trials were electronically searched from database inception to March 2022. We included cohort studies and RCTs that evaluated the impact of LT4 therapy on pregnancy and neonatal outcomes in euthyroid pregnant women with thyroid autoimmunity. Meta-analyses of different types of studies were performed separately, and meta-analyses were further performed by only including researches with low and moderate risk of bias. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to evaluate the quality of evidence, and used TSA to test the sufficiency of the evidence. Results: Finally, 2,901 euthyroid pregnant women with thyroid autoimmunity in six RCTs and five cohort studies were included. In all outcomes, no statistically significant differences were found between LT4 group and control group, including miscarriage [RR = 0.85, 95%CI (0.69,1.05), p = 0.14, I 2 = 1%], preterm birth [RR = 0.80, 95%CI (0.59,1.08), p = 0.14, I2 = 0%], preeclampsia [RR = 0.68, 95%CI (0.12, 3.91), p = 0.66, I 2 = 0%], placenta abruption [Peto' OR = 0.14, 95%CI (0.00, 6.94), p = 0.32, I 2 = 0%], birth weight [MD = -36.00, 95%CI (-170.41, 98.41), p = 0.60, I 2 = 0%], gestational age at delivery [MD = -0.10, 95%CI (-0.61, 0.41), p = 0.70, I 2 = 0%] and neonatal admission [RR = 1.33, 95%CI (0.21, 8.58), p = 0.76, I 2 = 0%]. The results for all outcomes were insufficient and inconclusive as demonstrated by TSA. The GRADE assessments showed that the quality of evidence of 4 outcomes (miscarriage, preterm birth, birth weight and gestational age at delivery) were moderate, and 3 outcomes (preeclampsia, placenta abruption and neonatal admission) were low or very low. Conclusion: For pregnancy and neonatal outcomes in euthyroid pregnant women with thyroid autoimmunity, we did not find benefit of LT4 treatment in this study. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022346745, identifier CRD42022346745.

Dataset Information

Impact of Thyroid Autoimmunity in euthyroid women on the outcomes of In Vitro Fertilization.

Objective

Methods

Results

Conclusion

Publications

Impact of Thyroid Autoimmunity in euthyroid women on the outcomes of In Vitro Fertilization.

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