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自身免疫性甲状腺炎与多囊卵巢综合征患者体外受精-胚胎移植妊娠结局相关性的研究

The relationship between autoimmune thyroiditis and pregnancy outcomes of patients with PCOS following in vitro fertilization and embryo transfer IVF-ET

摘要:

目的 通过分析育龄期多囊卵巢综合征(PC OS)患者体外受精-胚胎移植(IVF-ET)结局,探查自身免疫性甲状腺炎(AIT)是否影响患者IVF-ET妊娠结局.方法 入组患者为2010年5月至2014年12月于北京大学第三医院生殖中心行IVF-ET的PCOS女性,根据抗甲状腺抗体分为AIT组[抗甲状腺过氧化物酶抗体(TPOAb)和(或)甲状腺球蛋白抗体(TrGAb)阳性]与非AIT组(TPOAb和TGAb阴性),研究两组的不同妊娠结局,从而探究AIT是否影响IVF妊娠结局.结果 PCOS患者共490例,AIT组119例(24.3%),非AIT组371例(75.7%),AIT在PCOS患者中的发生率为24.3%,AIT与不同妊娠结局无相关性.促甲状腺激素(TSH)是妊娠的危险因素;高雄激素血症是临扇妊娠的危险因素;高泌乳素是分娩的危险因素,而TSH与分娩呈正相关.结论 PCOS患者AIT发病率高,AIT不是PCOS患者的IVF-ET不良妊娠结局的危险因素,PCOS患者本身的代谢紊乱(包括高胰岛素,高雄激素、高泌乳素)是导致不良妊娠的危险因素,AIT患者TSH偏高,所以临床给予了更多关注及监测,使其利于正常分娩.

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abstracts:

Objective To investigate the impact of autoimmune thyroiditis (AIT) on pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) following the in vitro fertilization and embryo transfer (IVF-ET) by analyzing their pregnancy outcomes.Methods The patients undergoing IVF-ET treatment diagnosed with PCOS in Peking University Third Hospital from May 2010 to December 2014 were investigated.According to the anti-thyroid antibodies (TPOAb or TGAb),patients were divided into AIT group and non-AIT group.The pregnancy outcomes of two groups were analysed for investigate the effect of AIT on pregnancy outcomes.Results Four hundred and ninety patients with PCOS were enrolled,119 (24.3%) of AIT group and 371 (75.7%) of non-AIT group.Patients with PCOS had a higher incidence (24.3%) of AIT.There was no correlation between AIT and the different pregnancy outcomes.TSH was negatively correlated with pregnancy as a risk factor.Hyperandrogenemia was negatively correlated with clinical pregnancy as a risk factor.Hyperprolactinemia was negatively correlated with delivery as a risk factor,while TSH was positively correlated with delivery.Conclusions The incidence of AIT was higher in patients with PCOS.AIT was not the risk factor of adverse pregnancy outcomes for PCOS women undergoing IVF.The metabolic disorders (including hyperinsulinemia,hyperandrogenemia and hyperprolactinemia)were the risk factors of adverse pregnancy outcomes.Patients in AIT group had the high TSH level.They should be received more care and monitoring to make it conducive to delivery.

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