摘要
目的探讨促甲状腺激素(TSH)和甲状腺过氧化物酶抗体(TPOAb)对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法选择2019年12月—2023年11月在合肥市妇幼保健院生殖医学中心接受IVF-ET治疗、游离甲状腺素正常和TSH在0.3~<10 mIU/L范围的患者为研究对象,按TSH水平分为0.3~<2.5 mIU/L、2.5~4 mIU/L和>4~<10 mIU/L 3组;游离甲状腺素和TSH均正常,按TPOAb水平分为TPOAb阳性组和TPOAb阴性组;比较不同TSH分组、TPOAb分组患者的生化妊娠率、临床妊娠率和自然流产率。结果纳入3876例IVF-ET患者,其中新鲜周期患者830例,复苏周期患者3046例。新鲜周期患者中,生化妊娠率、临床妊娠率和自然流产率分别为59.16%、52.77%和19.41%;不同TSH分组患者,TPOAb阳性和阴性患者的生化妊娠率、临床妊娠率和自然流产率差异无统计学意义(均P>0.05)。复苏周期患者中,生化妊娠率、临床妊娠率和自然流产率分别为55.52%、46.98%和20.27%;不同TSH分组患者,TPOAb阳性和阴性患者的生化妊娠率、临床妊娠率和自然流产率差异无统计学意义(均P>0.05)。随访2020—2022年接受IVF-ET治疗顺利分娩且TSH为>4~<10 mIU/L的150例患者,暂未发现子代智力发育问题或智力发育障碍倾向。结论游离甲状腺素处于正常范围情况下,本研究未发现TSH水平轻度升高和单纯TPOAb阳性对IVF-ET妊娠结局的影响。
Objective To investigate the effects of thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPOAb)on pregnancy outcomes of in vitro fertilization-embryo transfer(IVF-ET).Methods The patients who underwent IVF-ET at the Reproductive Medicine Center of Hefei Maternal and Child Health Care Hospital from December 2019 to November 2023,and had normal free thyroxine and 0.3-<10 mIU/L TSH levels were selected as subjects.The patients were divided into three groups based on TSH levels:0.3-<2.5 mIU/L,2.5-4 mIU/L,and>4-<10 mIU/L,and the patients with normal free thyroxine and TSH levels were further divided into TPOAb-positive and TPOAb-negative groups.The biochemical pregnancy rate,clinical pregnancy rate and miscarriage rate were compared among patients with different TSH and TPOAb groups.Results A total of 3876 patients were recruited,including 830 patients with fresh embryo transfer cycles and 3046 patients with frozen-thawed embryo transfer cycles.In the patients with fresh embryo transfer cycles,the biochemical pregnancy rate,clinical pregnancy rate and miscarriage rate were 59.16%,52.77% and 19.41%,respectively.In the patients with frozen-thawed embryo transfer cycles,these rates were 55.52%,46.98% and 20.27%,respectively.For both groups,there were no statistically significant differences in biochemical pregnancy rate,clinical pregnancy rate and miscarriage rate between TPOAb-positive and TPOAb-negative patients or among the patients with different TSH groups(all P>0.05).Additionally,a follow-up study of 150 patients who had successfully delivered after IVF-ET from 2020 to 2022 with TSH levels of>4–<10 mIU/L showed that no intellectual developmental issues or tendencies toward intellectual developmental disorders were found in their offsprings.Conclusion In the context of normal free thyroxine levels,this study did not find any impacts of mildly elevated TSH levels or isolated TPOAb positivity on the pregnancy outcomes of IVF-ET.
作者
万忠桂
洪名云
唐志霞
禹莉
WAN Zhonggui;HONG Mingyun;TANG Zhixia;YU Li(Maternal and Child Medical Center of Anhui Medical University/Fifth Clinical College of Anhui Medical University/Hefei Maternal and Child Health Hospital,Hefei,Anhui 230001,China)
出处
《预防医学》
2025年第3期316-320,324,共6页
China Preventive Medicine Journal
基金
安徽省临床重点学科(皖卫函〔2023〕320号)
2022年度安徽高校科学研究项目(2022AH050785)
合肥市第七周期重点学科(合卫医秘〔2023〕72号)
合肥市2022年度第三批市关键共性技术研发项目(GJ2022SM09)
合肥市卫健委应用医学研究项目(Hwk2022yb032)。
关键词
促甲状腺激素
甲状腺过氧化物酶抗体
体外受精-胚胎移植
妊娠结局
thyroid stimulating hormone
thyroid peroxidase antibody
in vitro fertilization-embryo transfer
pregnancy outcome
