POSTAL研究解读：左旋甲状腺素能改善甲状腺自身免疫妇女的妊娠结局吗？

Learning from POSTAL study： can levothyroxine improve pregnancy outcomes in women with thyroid autoimmunity？

目前尚不清楚左旋甲状腺素（LT4）治疗能否改善甲状腺自身抗体阳性但甲状腺功能正常妇女的体外受精一胚胎移植（IVF—ET）妊娠结局。甲状腺功能正常的甲状腺自身免疫状态妇女接受左旋甲状腺素治疗后的妊娠结局研究（Pregnancy Outcome Study in enthyroid women with Thyroid Autoimmunity after Levothyroxine，简称POSTAL研究）是一项随机对照临床试验，该研究人选了600例甲状腺过氧化物酶抗体阳性但甲状腺功能正常的妇女，随机分为两组，干预组在接受IVF-ET前2-4周开始给予LT4，对照组不给予LT4治疗。结果显示，与对照组相比，干预组的流产率、临床妊娠率及活产率均未见显著差异。因此，LT4治疗并不能改善甲状腺自身抗体阳性妇女的IVF-ET妊娠结局。

Whether levothyroxine （ LT4 ） treatment improves outcomes following in vitro fertilization and embryo transfer （IVF-ET） in euthyroid women who have tested positive for thyroid autoantibodies remains unclear. In Pregnancy Outcome Study in enthyroid women with Thyroid Autoimmunity after Levothyroxine （POSTAL） trial, which was a randomized controlled study involving 600 euthyroid women undergoing IVF-ET who were tested positive for thyroperoxidase antibodies, the miscarriage rate, clinical pregnancy rate and live-birth rate were not significantly different between the LT4 intervention group and control group. Therefore, LT4 treatment did not appear to improve pregnancy outcomes among women with thyroid autoantibodies undergoing IVF-ET.