Prevalence of Anti-Thyroid Peroxidase Antibody positivity and its Effect on Pregnancy Outcome in women with Unexplained infertility

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, School of medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

2 Department of Community Medicine, School of medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Abstract

Introduction:
Thyroid disease is the second endocrine disorder that affects women in reproductive age and its autoimmunity can affect the outcome of the pregnancy. The aim of this study was to investigate the prevalence of Anti-TPO positivity and its effect on pregnancy outcomes in women with unexplained infertility.
 Materials and Methods:
In this cross-sectional descriptive study, 93 infertile women who referred to infertility center at Ardabil city during 2020-2021 were recruited for the study. Information such as age, BMI, TSH, prolactin and results of Anti-TPO were completed for all cases and then analyzed by statistical methods in SPSS version 23. 
 Results:
The prevalence of anti-TPO positivity was 73.1% (n=68). The mean of BMI, Age, TSH and prolactin were not significantly different in women with Anti-TPO positivity as compared to others. There was no relation between TSH and Anti-TPO results and Also between TSH and results of pregnancy.
 Conclusion:
Our results indicate that anti-TPO screening in pregnancy, may aid in early identification of the women at risk at the future.

Keywords

Main Subjects


  1. Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010;31(5):702–55.
  2. Tulandi T, Al-Fozan H. Definition and etiology of recurrent pregnancy loss [Internet]. UpToDate. Wolters Kluwar; 2019. Available from: https://www.uptodate.com/contents/definition-and-etiology-of-recurrent-pregnancy-loss/print
  3. Matalon ST, Blank M, Ornoy A SY. The association between anti-thyroid antibodies and pregnancy loss. Am J Reprod Immunol. 2001; 45(2):72–7.
  4. Seungdamrong A, Steiner AZ, Gracia CR. Preconceptional antithyroid peroxidase antibodies , but not thyroid-stimulating hormone , are associated with decreased live birth rates in infertile women. Fertil Steril [Internet]. 2017; 108(5): 843–50. Available from: https://doi. org/10.1016/j.fertnstert.2017.08.026
  5. Monteleone P, Parrini D, Faviana P, Carletti E, Uccelli A, Cela V, et al. Female infertility related to thyroid autoimmunity: the ovarian follicle hypothesis. Am J Reprod Immunol. 2011; 66(2): 108-14.
  6. McElduff A, Morris J. Thyroid function tests and thyroid autoantibodies in an unselected population of women undergoing first trimester screening for aneuploidy. Aust N Z J Obstet Gynaecol. 2008; 48:478–80.
  7. 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. 
  8. Prummel MF, Wiersinga WM. Thyroid peroxidase autoantibodies in euthyroid subjects. Best Pract Res Clin Endocrinol Metab. 2005;19:1–15. 
  9. Debieve F, Duliere S, Bernard P. et al. To treat or not to treat euthyroid autoimmune disorder during pregnancy? Gynecol Obstet Invest. 2009; 67: 178–82. 
  10. Zhong Y, Ying Y, Wu H, Zhou C, Xu Y, Wang Q, et al. Relationship between Antithyroid Antibody and Pregnancy Outcome following in Vitro Fertilization and Embryo Transfer. Int J Med Sci. 2012; 9(2):121–5.
  11. Poppe K, Glinoer D, Tournaye H, Devroey P, Schiettecatte J, Haentjens P VB. Thyroid autoimmunity and female infertility. Verh K Acad Geneeskd Belg. 68(5–6):357–77.
  12. Habibzhde V, Faghih N. study of prevalence of Anti-Thyroid Peroxidase (TPO) antibodies in eutgyroid women with unexplained infertility referred to IVF center in Afzalipour hospital in 2013-2014. J Shahid Sadoughi Univ Med Sc. 2017; 24(12):972–80.
  13. Meena M, Chopra S, Jain V, Aggarwal N. The Effect of Anti-Thyroid Peroxidase Antibodies on Pregnancy Outcomes in Euthyroid Women. Obstet Gynaecol. 2016;10(9):10–3.
  14. Roberto Negro, Gianni Formoso, Tiziana Mangieri, Antonio Pezzarossa, Davide Dazzi HH. Levothyroxine Treatment in Euthyroid Pregnant Women with Autoimmune Thyroid Disease: Effects on Obstetrical Complications. J Clin Endocrinol Metab. 2006;91(7):2587–2591.
  15. Casey BM, Jodi S Dashe, C Edward Wells, Donald D McIntire, William Byrd, Kenneth J Leveno FGC. Subclinical hypothyroidism and pregnancy outcomes. Obs Gynecol. 2010; 105(2): 239-45.
  16. Karmon AE, Batsis M, Chavarro JE, Souter I. Preconceptional thyroid-stimulating hormone levels and outcomes of intrauterine insemination among euthyroid infertile women. Fertil Steril. 2014;103(1):258–63.
  17. Chai J, Yeung W-YT, Lee C-Y V, Li H-WR, Pak-Chung Ho H-YEN. Live birth rates following in vitro fertilization in women with thyroid autoimmunity and/or subclinical hypothyroidism. Clin Endocrinol. 2014;80(1):122–7.
  18. Negro R, A. Schwartz, R. Gismondi, A. Tinelli, T. Mangieri AS-G. Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. J Clin Endocrinol Metab. 2010; 95(9): 44–8.
  19. Balthazar U, ZStainer A. Periconceptional changes in thyroid function: a longitudinal study. Reprod Biol Endocrinol. 2012;2012 ;10:2.
  20. Negro R, Mangieri T, Coppola L, Presicce G, Eugenio Caroli Casavola, Riccardo Gismondi GL, Paolo C, et al. Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study. Hum Reprod. 2005;20(6):1529–33.
  21. Unuane D, Velkeniers B, Bravenboer B, Drakopoulos P, Tournaye H, Parra J, et al. Impact of thyroid autoimmunity in euthyroid women on live birth rate after IUI. Reprod Endocrinol. 2017; 32(4):915–22.
  22. Kaprara A, Krassas GE. Thyroid autoimmunity and miscarriage. Hormones (Athens) 2008;7:294–302. 
  23. Artini PG, Uccelli A, Papini F, Simi G, Maria O, Berardino D, et al. Infertility and pregnancy loss in euthyroid women with thyroid autoimmunity. 2013;29(1):36–41.
  24. Zhang Y, Wang H, Pan X, Teng W, Shan Z. Patients with subclinical hypothyroidism before 20 weeks of pregnancy have a higher risk of miscarriage: A systematic review and meta-analysis. PLoS One. 2017;12(4):e0175708.