Endocrine Abstracts

JOINT2324

Introduction: Autoimmune thyroid disease (AITD) is among the most common endocrine disorders and occurs more frequently in women. Circulating antithyroid antibodies associated with AITD are known to affect various tissues, including the ovaries. As a result, this prevalent condition may influence female fertility, which is the focus of the present research. The aim of this study is to explore the role of anti-TPO antibodies in ovarian reserve and early embryo development in assisted reproductive technology (ART) based on the existing literature.

Material and Methods: Data regarding AITD and female reproduction, ovarian reserve and embryo development in ART were searched in MedLine, PubMed, WebofScience, Scopus, Google Scholar data base. Data were combined and presented as main conclusion.

Results: Infertility is a major global health concern, yet in-vitro fertilization (IVF) success rates remain low (8.6-46.2%). The molecular mechanisms linking reduced fertility to the presence of thyroid antibodies remain unclear. One important area of investigation is the role of immunological markers, specifically circulating autoantibodies, that impact female fertility. There are potential ways that anti-TPO antibodies could negatively affect the reproductive system, particularly ovarian tissue, can pass into the ovaries and have been found in the fluid surrounding eggs, targeting the zona pellucida in women with ovarian inflammation also reacted and suggests that ATPO might bind to the zona pellucida, potentially disrupting fertilization, embryo development, and implantation. Recent findings indicate a strong correlation between thyroid hormone levels in serum and follicular fluid. Additionally, the ratio of T4 to T3 in follicular fluid, along with serum TSH levels, showed a positive association with the number of retrieved oocytes, including mature ones, as well as the number of embryos. Relationship between ovarian reserve and the presence of anti-thyroid autoantibodies is limited. It is reasonable to suggest that fibrotic changes may develop in the ovary as part of the typical inflammatory response, potentially impacting ovarian reserve. Indeed, some studies have reported a decline in key markers of functional ovarian reserve in patients with AITD.

Conclusion: Although the impact of thyroid autoimmunity on natural conception and ART success rates is still a subject of debate, the current study suggests that the presence of antithyroid autoantibodies, including ovarian function, the composition of follicular fluid (which serves as the environment for oocyte maturation), as well as folliculogenesis and embryogenesis. Therefore, presence anti-TPO antibodies in the blood can reflect its follicular fluid level and can impact IVF outcomes.