TPOAb positivity can impact ovarian reserve, embryo quality, and IVF/ICSI outcomes in euthyroid infertile women

Figures & data

Figure 1. Flowchart of the study selection process. ART: assisted reproductive technology/BMI: body mass index/TPOAb: thyroid peroxidase antibody/TGAb: thyroid globulin antibody

Table 1. Comparison of baseline characteristics of TPOAb-positive and TPOAb-negative women.

Characteristics	TPOAb positive (n = 86)	TPOAb negative (n = 177)	P
Female age (years)	32.89 ± 3.18	32.21 ± 4.02	0.171
BMI (kg/m2)	22.84 ± 3.66	22.23 ± 3.46	0.188
TSH (IU/L)	2.04 ± 1.12	2.02 ± 0.92	0.840
FT4 (ng/dl)	16.57 ± 2.85	16.29 ± 2.08	0.357
FT3 (ng/dl)	4.96 ± 0.55	5.04 ± 0.49	0.273
FSH (IU/L)	7.10 ± 2.19	6.67 ± 1.94	0.109
LH (IU/L)	5.77 ± 2.53	5.75 ± 3.01	0.966
E2(ng/L)	152.57 ± 59.39	151.87 ± 63.81	0.932
PROG (nmol/L)	1.12 ± 0.66	1.02 ± 0.69	0.270
AMH (ng/mL)	2.37(1.26 ∼ 3.63)	3.54(1.74 ∼ 5.41)	<0.001*
AFC	10.05 ± 8.37	11.93 ± 8.73	0.097
Causes of infertility			0.840
Ovulatory dysfunction and anovulation (n, %)	13 (15.11)	33 (18.64)
Tubal Infertility (n, %	11 (12.79)	16 (9.04)
Endometrial and cervical factors (n, %)	10 (11.63)	21 (11.86)
Male Factor (n, %)	35 (40.69)	68 (38.42)
unexplained infertility (n, %)	17 (19.77)	39 (22.03)

Note: Values are mean ± SD, median (quartile), n (%). BMI: Body mass index; AFC: antral follicle count.

Table 2. Comparison of IVF/ICSI cycle treatment indicators and pregnancy outcomes in TPOAb-positive and TPOAb-negative women.

	TPOAb positive (n = 86)	TPOAb negative (n = 177)	P
Gn use days (day)	8.52 ± 2.61	8.23 ± 1.98	0.307
Total Gn Dose (IU)	1734.83 ± 818.06	1515.40 ± 599.07	0.028
No. of eggs retrieved	8 (5 ∼ 12)	10 (6 ∼ 15)	0.006
No. of MII eggs	6 (4 ∼ 10)	8 (5 ∼ 13)	0.010
Fertilization rate (%)	623/663 (93.97)	1522/1678 (90.70)	0.010
Cleavage rate (%)	527/623 (84.59)	1286/1522 (84.49)	0.955
High-quality embryo rate (%)	211/527 (40.04)	585/1286 (45.49)	0.034
No. of embryos transferred	1.37 ± 0.48	1.42 ± 0.49	0.664
Blood positive rate (%)	40/86 (46.51)	90/177 (50.85)	0.515
Clinical pregnancy rate (%)	32/86 (37.21)	82/177 (46.33)	0.185
Miscarriage rate (%)	12/32 (37.50)	15/82 (18.29)	0.048
Live birth rate (%)	20/86 (23.26)	67/177 (37.85)	0.025

Note: Values are mean ± SD, median (quartile), n (%).

Table 3. Subgroup analyses of pregnancy outcomes according to median TPOAb titers.

	High titers (n = 43)	Low titers (n = 43)	P
No. of embryos transferred	1.54 ± 0.51	1.41 ± 0.49	0.228
Blood positive rate (%)	18/43 (41.86)	22/43 (51.16)	0.387
Clinical pregnancy rate (%)	13/43 (30.23)	19/43 (44.19)	0.181
Miscarriage rate (%)	7/13 (53.85)	5/19 (26.32)	0.227
Live birth rate (%)	6/43 (13.95)	14/43 (32.56)	0.041

Note: Values are mean ± SD, median (quartile), n (%).

Table 4. Logistic regression analysis to Identify factors affecting live birth outcomes.

Influencing factors	B	S.E.	Wald χ2	P	OR (95% C.I)
Age	−0.037	0.035	1.084	0.298	0.964 (0.889 ∼ 1.033)
No. of retrieved oocytes	0.066	0.035	3.608	0.057	1.068 (0.998 ∼ 1.144)
No. of cleavage oocytes	0.136	0.064	4.526	0.033	1.145 (1.011 ∼ 1.298)
TPOAb titers	−1.091	0.547	3.972	0.046	0.336 (0.115 ∼ 0.982)

Figure 2. Mechanism of specific effects of ATA on clinical outcomes of IVF/ICSI.