甲状腺自身抗体阳性对体外受精-胚胎移植结局的影响

目的：探讨抗甲状腺自身抗体（antithyroid autoantibodies，ATA）阳性对体外受精．胚胎移植泐vitro fertilization and embryo transfer，ⅣF—ET）结局的影响。方法：回顾性分析行IVF／ICSI治疗不孕的患者资料。选取甲状腺抗体阳性但甲状腺功能正常者65例（共71个周期）作为研究组（ATA＋组），492例甲状腺抗体阴性患者（共512个周期）作为对照组（ATA组）。结果：ATA＋组与ATA-患者的一般情况、促排卵天数、促性腺激素使用总量（Gn总量）、hCG注射日E2水平、获卵数、ICSI受精率、可移植胚胎数和妊娠率，组间比较均无统计学差异（P〉0．05）。ATA＋组IVF受精率（59．73％）、优质胚胎率（26．94％）明显低于ATA-组（70．86％和36．31％）；ATA＋组的流产率（37．50％）明显高于ATA组（17．79％），差异有统计学意义（P〈0．05）。结论：ATA＋对IvF—ET妊娠结局有不利的影响，因此，对于ATⅣ患者在接受IVF—ET治疗前调节甲状腺自身免疫功能可对妊娠结局有利。

Impact of Antithyroid Antibody Positive on the Outcome of In Vitro Fertilization and Embryo Transfer

Objective： To investigate the impact of antithyroid autoantibodies （ATA） on pregnancy outcome in the in vitro fertilization and embryo transfer （IVF-ET） patients. Methods： A total of 65 infertile women （71 cycles） who were antithyroid antibody positive （ATA＋ group） and 492 infertile women （512 cycles） who were antithyroid antibody negative （ATA- group） undergoing IVF/ICSI were retrospectively analyzed. Results： There was no significant difference in the days of ovarian stimulation, total gonadotropin dosage, serum E2 level on hCG injection day, the number of oocytes retrieved, the fertility rate of ICSI, the number of available embryos and the pregnancy rate between the two groups. The IVF fertilization rate, the high-quality embryo rate were significantly lower in ATA＋ group than in ATA- group （59.73% vs 70.86%, 26.94% vs 36.31%）. Abortion rate was significantly higher in ATA＋ group than in the control （37.50% vs 17.79%）. Conclusion： The ATA positive is detrimental for the pregnancy outcome following IVF-ET. Therefore, regulating thyroid autoimmune function before and during IVF treatment may have some benefits for pregnancy outcome.