TY - JOUR
T1 - Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women
AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network
AU - Seungdamrong, Aimee
AU - Steiner, Anne Z.
AU - Gracia, Clarisa R.
AU - Legro, Richard S.
AU - Diamond, Michael Peter
AU - Coutifaris, Christos
AU - Schlaff, William D.
AU - Casson, Peter
AU - Christman, Gregory M.
AU - Robinson, Randal D.
AU - Huang, Hao
AU - Alvero, Ruben
AU - Hansen, Karl R.
AU - Jin, Susan
AU - Eisenberg, Esther
AU - Zhang, Heping
AU - Santoro, Nanette
N1 - Funding Information:
This work was supported by NIH/NICHD grants R25 HD075737, U10 HD39005 (to M.P.D.), U10 HD38992 (to R.S.L.), U10 HD27049 (to C.C.), U10 HD38998 (to R.A.), U10 HD055942 (to R.D.R.), HD055944 (to P.C.), U10 HD055936 (to G.M.C.), U10 HD055925 (to H.Z.), U10 HD077844 (to A.Z.S), and U10 U54-HD29834 (to the University of Virginia Center for Research in Reproduction Ligand Assay and Analysis Core of the Specialized Cooperative Centers Program in Reproduction and Infertility Research). This research was made possible by the funding by American Recovery and Reinvestment Act. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or NIH.
Funding Information:
A.S. reports grants from National Institutes of Health/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH/NICHD) during the conduct of the study. A.Z.S. reports grants from NIH/NICHD during the conduct of the study. C.R.G. has nothing to disclose. R.S.L. reports he is a consultant for Bayer, Kindex, Euroscreen, Takeda, Clarus, Astra Zeneca, and Sprout; and has grants from Astra Zeneca and Ferring. M.P.D. reports grants from NIH/NICHD during the conduct of the study; and grants from Advanced Reproductive Care, AbbVie, and Bayer, outside the submitted work. C.C. reports grants from NIH/NICHD outside the submitted work. W.D.S. has nothing to disclose. P.C. has nothing to disclose. G.M.C. reports grants from NIH/NICHD during the conduct of the study; and is a clinical trial site principal investigator and consultant for Abbvie Pharmaceuticals, outside the submitted work. R.D.R. reports grants from NIH/NICHD during the conduct of the study and AbbVie, outside the submitted work. H.H. has nothing to disclose. R.A. reports grants from NIH/NICHD, during the conduct of the study. K.R.H. Hansen reports grants from NIH/NICHD, during the conduct of the study; and grants from Roche Diagnostics and Ferring International Pharmascience Center US, outside the submitted work. S.J. has nothing to disclose. E.E. has nothing to disclose. H.Z. reports grants from NIH/NICHD, during the conduct of the study. N.S. has nothing to disclose.
Publisher Copyright:
© 2017
PY - 2017/11
Y1 - 2017/11
N2 - Objective To study whether preconceptual thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) antibodies are associated with poor reproductive outcomes in infertile women. Design Secondary analysis of data from two multicenter, randomized, controlled trials conducted by the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Multivariable logistic regression analyses were performed to assess the association between preconceptual TSH levels and anti-TPO antibodies. Setting Not applicable. Patient(s) Serum samples from 1,468 infertile women were utilized. Intervention(s) None. Main Outcome Measure(s) Cumulative conception, clinical pregnancy, miscarriage, and live birth rates were calculated. Result(s) Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs. TSH < 2.5 mIU/L. Women with anti-TPO antibodies had similar conception rates (33.3% vs. 36.3%) but higher miscarriage rates (43.9% vs. 25.3%) and lower live birth rates (17.1% vs. 25.4%) than those without anti-TPO antibodies. Adjusted, multivariable logistic regression models confirmed elevated odds of miscarriage (odds ratio 2.17, 95% confidence interval 1.12–4.22) and lower odds of live birth (oddr ratio 0.58, 95% confidence interval 0.35–0.96) in patients with anti-TPO antibodies. Conclusion(s) In infertile women, preconceptional TSH ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, anti-TPO antibodies are associated with increased risk of miscarriage and decreased probability of live birth. Clinical Trial Registration Number PPCOS II NCT00719186; AMIGOS NCT01044862.
AB - Objective To study whether preconceptual thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) antibodies are associated with poor reproductive outcomes in infertile women. Design Secondary analysis of data from two multicenter, randomized, controlled trials conducted by the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Multivariable logistic regression analyses were performed to assess the association between preconceptual TSH levels and anti-TPO antibodies. Setting Not applicable. Patient(s) Serum samples from 1,468 infertile women were utilized. Intervention(s) None. Main Outcome Measure(s) Cumulative conception, clinical pregnancy, miscarriage, and live birth rates were calculated. Result(s) Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs. TSH < 2.5 mIU/L. Women with anti-TPO antibodies had similar conception rates (33.3% vs. 36.3%) but higher miscarriage rates (43.9% vs. 25.3%) and lower live birth rates (17.1% vs. 25.4%) than those without anti-TPO antibodies. Adjusted, multivariable logistic regression models confirmed elevated odds of miscarriage (odds ratio 2.17, 95% confidence interval 1.12–4.22) and lower odds of live birth (oddr ratio 0.58, 95% confidence interval 0.35–0.96) in patients with anti-TPO antibodies. Conclusion(s) In infertile women, preconceptional TSH ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, anti-TPO antibodies are associated with increased risk of miscarriage and decreased probability of live birth. Clinical Trial Registration Number PPCOS II NCT00719186; AMIGOS NCT01044862.
KW - Antibodies
KW - autoimmunity
KW - infertility
KW - pregnancy
KW - spontaneous abortion
KW - thyroid
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U2 - 10.1016/j.fertnstert.2017.08.026
DO - 10.1016/j.fertnstert.2017.08.026
M3 - Article
C2 - 29102040
AN - SCOPUS:85032815227
SN - 0015-0282
VL - 108
SP - 843
EP - 850
JO - Fertility and sterility
JF - Fertility and sterility
IS - 5
ER -
