Subclinical hypothyroidism and thyroid autoimmunity in women with infertility
Subclinical hypothyroidism and thyroid autoimmunity in women with infertility
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DOI：
10.1080/09513590701259542
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发表时间：
2007-05-01
影响因子：
2
通讯作者：
Levalle, Oscar
中科院分区：
文献类型：
--
作者：
Abalovich, Marcos;Mitelberg, Laura;Levalle, Oscar
Objective.确定不孕妇女中不同亚临床甲状腺功能减退（SH）分级和甲状腺自身免疫（TAI）的患病率。回顾性研究。设置。阿根廷一家公立医院的内分泌科。第一组包括244名咨询不孕症的妇女（> 1年未怀孕）; C组（对照组）包括155名健康妇女，确认生育。在所有患者中测定促甲状腺激素和甲状腺过氧化物酶抗体，并在71例患者中进行促甲状腺激素释放激素（TRH）刺激试验以诊断SH 1级。甲状腺功能减退妇女接受左旋甲状腺素治疗的妊娠率也进行了评估。I组和C组分别有13.9%和3.9%的患者诊断为SH（p < 0.002）。TRH兴奋试验可检出12.7%的不孕患者的SH 1级。卵巢早衰、输卵管功能障碍和排卵功能障碍患者的SH发生率（分别为40.0%、18.2%和15.4%）高于对照组（p < 0.0001、p < 0.002和p < 0.003）。与C组相比，I组TAI患病率无显著差异。左旋甲状腺素治疗的妊娠率为44.1%。我们观察到不孕症患者中SH的患病率较高，但TAI的患病率不高。我们的研究结果支持甲状腺筛查妇女生殖失败。
Objective. To determine the prevalence of different subclinical hypothyroidism (SH) grades and thyroid autoimmunity (TAI) in infertile women.Design. Retrospective study.Setting. Endocrinology division of a public hospital in Argentina.Patients. Group I comprised 244 women consulting on infertility (> 1 year without pregnancy); Group C (controls) comprised 155 healthy women with confirmed fertility.Intervention. Thyroid-stimulating hormone and thyroid peroxidase antibodies were measured in all patients, and a thyrotropin-releasing hormone (TRH) stimulation test was performed in 71 patients to diagnose SH grade 1. The pregnancy rate in hypothyroid women on levothyroxine treatment was also evaluated.Results. SH was diagnosed in 13.9% of the patients in Group I and in 3.9% of Group C (p < 0.002). The TRH stimulation test was useful to detect SH grade 1 in 12.7% of the infertile patients. Patients with precocious ovarian failure, tubal disturbances and ovulatory dysfunction presented higher SH rates (40.0, 18.2 and 15.4%, respectively) than control patients (p < 0.0001, p < 0.002 and p < 0.003). No significant difference in TAI prevalence was shown in Group I relative to Group C. Pregnancy rate of 44.1% was achieved under levothyroxine treatment.Conclusions. We observed a higher prevalence of SH, but not of TAI, in patients with infertility. Our results support thyroid screening in women with reproductive failure.