Endocrine Abstracts

JOINT3547

Introduction: The impact of thyroid autoimmunity on female fertility and assisted reproductive technology (ART) outcome is still controversial.

Aim: The aim of this study was to evaluate the impact of thyroid autoantibodies (TAA) on ovarian reserve, ovarian response and oocyte quality in euthyroid infertile patients undergoing ART.

Material and Method: Retrospective study on 294 women undergoing ART at the University Hospital of Padua. Every patient underwent to the evaluation of FSH, LH, 17β-estradiol, TSH, free thyroxine (fT4), anti-thyroid peroxidase antibody (anti-TPO), anti-tireoglobulin antibody (anti-TG) and anti-Müllerian hormone (AMH) on the 2nd–5th day of menstrual cycle. In the same moment, pelvic sonography was performed to estimate antral follicle count (AFC). All patients underwent a standardized controlled ovulation stimulation (COS) process and the number and quality of retrieved oocytes was evaluated. Exclusion criteria: TSH >4 mUI/L; previous or concomitant medications for thyroid disease.

Results: The mean age of the patients was 37.6 years and the BMI was 23.7 kg/m². Three patients with TSH>4 mUI/lwere excluded. Of the 199 patients undergoing CS, 42 presented at least one thyroid autoantibody (TAA+): 22 were positive for both TAA, 6 for anti-TG only, 14 for anti-TPO only. Based on Bologna criteria, 60% were normo-responders, 19% poor-responders, and 21% high-responders. A total of 1348 oocytes was retrieved, including 285 in patients with TAA+ and 1063 in patients with negative antibodies (TAA-). Comparison of normo, poor and high-responders showed no statistically significant differences in BMI and TTA positivity. Considering the two groups TAA+ and TAA-, no statistically significant differences emerged for AMH levels, AFC, total oocyte count and rate of mature oocytes at pick-up. TSH was higher on average in the TAA+ group than in the TAA-. AMH and AFC values were significantly lower in patients with anti-TPO only compared with those with anti-TG only. In contrast, there was no evidence of a difference in the number of total and mature oocytes according to TAA positivity.

Conclusions: The presence of anti-TPO is associated with a decreased ovarian reserve, but it seems to be not correlated to a poor response in ART. Further studies are needed to better evaluate the impact of anti-TPO on female fertility and ART outcomes.