Serum thyroid-stimulating hormone receptor antibody levels and thyroid dysfunction after hysterosalpingography: a case-control study

Abstract

Objective

Hysterosalpingography (HSG) performed with an iodine contrast media can cause thyroid dysfunction, including thyrotoxicosis and hypothyroidism. We investigated the association between the serum levels of thyroid-stimulating hormone receptor antibody (TRAb), an indicator of Graves’ disease, and abnormal thyroid function after performing HSG.

Methods

The screening of TRAb was conducted in 362 patients who first visited the Tawara IVF Clinic between April and September 2018. The association between TRAb levels and the effects of HSG examinations on thyroid function were evaluated.

Results

Of the 362 patients, 2 (0.55%) had high levels (>2.0 IU/L) of TRAb, whereas 18 (5.0%) had intermediate TRAb levels, ranging from 0.3 to 1.9 IU/L. Of the 98 women (including 7 of the 18 women with TRAb level 0.3–1.9 IU/L, and 91 of the 342 women with TRAb level <0.3 IU/L) who had undergone HSG, two women developed overt thyrotoxicosis after HSG, and the frequency was significantly higher (p = .0044) in the group with intermediate levels of TRAb (28.6%, 2 of 7) than that in the group with low TRAb levels (<0.3 IU/L; 0.0%, 0 of 91).

Conclusions

These findings indicate that increased serum levels of TRAb are significantly associated with the development of thyrotoxicosis after HSG.

血清促甲状腺激素受体抗体水平和子宫输卵管造影术后甲状腺功能异常：病例对照研究 摘要

目的：用碘造影剂进行子宫输卵管造影术（HSG）可导致甲状腺功能异常, 包括甲状腺功能亢进和甲状腺功能减退。我们研究了血清促甲状腺激素受体抗体（TRAb）的水平, Graves疾病的一种指标, 和HSG后甲状腺功能异常之间的关系。

方法：TRAb的筛查是在362名患者中进行的, 患者是于2018年4月至9月首诊于Tawara IVF诊所。评估了TRAb水平与HSG检查对甲状腺功能的影响之间的关系。

结果：在362例患者中, 2例（0.55％）TRAb高水平（> 2.0 IU / L）, 18例（5.0％）TRAb中等水平, 0.3-1.9 IU / L。在98例经历HSG的女性（7个女性TRAb水平0.3-1.9 IU / L, 91个女性TRAb水平<0.3 IU / L）中, 2例发生了明显的甲状腺功能亢进, TRAb中等水平组的发生比例（28.6％, 2 / 7）显著高于（p=.0044）TRAb低水平组（<0.3 IU / L, 0.0％, 0 / 91）。

结论：这些发现表明, 在HSG后, 血清TRAb水平的增加与甲状腺功能异常的发生显著相关。

Keywords:

• Thyroid function
• TRAb
• infertility
• hysterosalpingography (HSG)
• thyrotoxicosis

Acknowledgments

The authors thank Morihiro Tomomatsu (MET-SL) for discussion.

Disclosure statement

S. So and N. Murabayashi are employed at the laboratory of the Tawara IVF Clinic, which funded the study.