甲状腺自身性免疫与辅助生殖

Thyroid Autoimmunity and Assisted Reproduction

甲状腺自身抗体可能与流产风险增加有关,但是否存在因果关系及相关机制尚不明确。甲状腺自身性免疫(thyroid autoimmunity,TAI)对辅助生殖结局的影响尚存争议。现有研究表明使用左旋甲状腺素、糖皮质激素、免疫球蛋白等改善TAI女性辅助生殖结局的证据不足,有待进一步研究。未来研究应探索甲状腺自身抗体与不良妊娠之间的因果关系。在研究设计时应考虑到甲状腺自身抗体滴度、不同授精方式、进行新鲜胚胎移植及冻融胚胎移植等因素的影响。需进一步研究卵细胞质内单精子注射/冻融胚胎移植是否更有利于行辅助生殖治疗的TAI女性的妊娠结局。

Thyroid autoantibodies may be associated with the increased risk of miscarriage,but whether there is a causal relationship and the related mechanism is not clear.The effect of thyroid autoimmunity(TAI)on the outcomes of assisted reproduction is a controversial topic for a long time.Existing studies have shown that the evidence of levothyroxine,glucocorticoid,immunoglobulin and so on,using to improve the outcomes of assisted reproduction in TAI women is insufficiency.It is needed to study further in future.The causal relationship between thyroid autoantibodies and adverse pregnancy should be further explored.In the research design,thyroid autoantibody titer,different insemination methods and fresh embryo transfer or frozen embryo transfer should be considered.It is necessary to further study whether intracytoplasmic sperm injection/frozen embryo transfer(ICSI/FET)is more beneficial to the pregnancy outcomes of TAI women undergoing assisted reproduction.