Antithyroid antibodies may predict serum beta HCG levels and biochemical pregnancy losses in euthyroid women with IVF single embryo transfer

Abstract

Objective

To investigate the relationship between thyroid autoimmunity and early pregnancy serum β-HCG levels in intracytoplasmic sperm injection patients.

Methods

The study subjects were 85 female euthyroid patients undergoing intracytoplasmic sperm injection embryo transfer cycles with GnRH antagonist treatment. Patients who received transfer of more than one embryo, those with serum TSH levels of greater than 2.5 IU/ml and subjects using levothyroxine were excluded. Normal responder patients under the age of 40 years were randomly selected from the patient files retrospectively. Subjects were divided into two groups: those with autoimmune thyroid disease (thyroid autoimmunity group; n = 39) and those without the disease (control group; n = 46).

Results

The age, body mass index, trial number, total rFSH treatment dose, the number of cumulus oophorus complexes, number of metaphase II oocytes, and number of 2-pronuclei embryos were similar in the thyroid autoimmunity and control groups. Serum β-HCG levels measured on the 14th day after oocyte pickup were significantly lower in the thyroid autoimmunity group than in the control group (93.8 ± 35.8 versus 128.5 ± 55.8 mlU/ml, respectively; p < .001). The miscarriage rate was higher in the thyroid autoimmunity group than in the control group (34.4% versus 21.7%, respectively; p = .034).

Conclusion

We found that early-stage pregnancy serum β-HCG hormone levels among euthyroid patients undergoing intracytoplasmic sperm injection were lower in subjects with thyroid autoimmunity than in those without thyroid autoimmunity. This result, reported for the first time in the literature on euthyroid pregnant women with thyroid autoimmunity, may be predictor of early pregnancy losses in pregnant women with thyroid autoimmunity.

Key message

• In intracytoplasmic sperm injection (ICSI)/IVF patients, due to lack of evidence-based data about the relationship between thyroid autoimmunity and pregnancy loss the current research was conducted. Early-stage pregnancy serum β-HCG hormone levels in euthyroid ICSI patients with thyroid autoimmunity are lower than those without autoimmunity which may be associated with early pregnancy losses.

抗甲状腺抗体可以预测甲状腺功能正常女性体外受精单胚移植后血清β-HCG水平和生化妊娠丢失 摘要

目的：探讨卵母细胞胞浆内单精子注射患者早期妊娠血清β-HCG水平与甲状腺自身免疫的关系。

方法：85例甲状腺功能正常患者, 经GnRH拮抗剂治疗的卵母细胞胞浆内单精子注射胚胎移植周期。排除了接受多个胚胎移植的患者、血清TSH水平大于2.5 IU/ml的患者和应用左旋甲状腺素的受试者。从回顾性的患者档案中随机选取40岁以下的正常应答患者。研究对象分为两组:自身免疫性甲状腺疾病(甲状腺自身免疫组;n =39)和未患病组(对照组;n = 46)。

结果:甲状腺自身免疫组和对照组的年龄、体重指数、试验次数、总剂量、卵丘复合体数量、中期卵母细胞数量和2个原核胚胎数量相似。甲状腺自身免疫组在取卵后第14天检测到的血清β-HCG水平明显低于对照组(分别为93.8±35.8 vs 128.5±55.8 mlU/ml；p < .001)。自身免疫组的流产率高于对照组(34.4% vs 21.7%；p = .034)。

结论:甲状腺功能正常的患者接受卵胞胞浆内单精子注射后, 甲状腺自身免疫组早期妊娠血清β-HCG水平低于对照组。这是文献中首次报道甲状腺正常孕妇伴有甲状腺自身免疫, 可能是患有甲状腺自身免疫孕妇早期生化妊娠的预测因素。

Keywords:

• β-HCG
• intracytoplasmic sperm injection
• thyroid autoimmunity
• pregnancy
• miscarriage
• GnRH antagonist treatment

Disclosure statement

The authors report no conflict of interest.