Yingqin Huang, Baoli Xie, Jiaxu Li, Fu Hang, Qianwen Hu, Yufu Jin, Rongyan Qin, Jiaxin Yu, Jianxin Luo, Ming Liao, Aiping Qin
Journal: BMC women's health 2024;24(1):630
PMID: 39604908
Infertility affects a significant number of women worldwide and can be influenced by various factors, including autoimmune disorders. Thyroid autoimmunity (TAI), defined by the presence of circulating anti-thyroid antibodies targeting thyroid peroxidase (TPOAb), thyroglobulin (TgAb), and anti-microparticle protein (TmAb), is the most frequent cause of thyroid dysfunction The aim of this study was to analyse the prevalence of thyroid autoantibody positivity in women experiencing infertility. This study is a systematic review and meta-analysis of fifty-four articles. The study designs comprised 25 retrospective cohort studies, 15 prospective cohort studies, and 14 case-control studies. Results showed that although TAI is not a direct cause of infertility, widespread positive rates of thyroid autoantibodies in women with infertility have been reported in the literature. Authors concluded that the findings indicate a notable association between thyroid autoantibody positivity and infertility in women. This highlights the importance of screening for thyroid autoantibodies in the diagnostic workup of infertile women.
BACKGROUND
Thyroid autoimmunity (TAI) is associated with infertility and complications during pregnancy. However, the prevalence of thyroid autoantibodies in women with infertility remains unclear due to variability in study designs, sample sizes, and populations. In this meta-analysis, we aimed to assess the prevalence of thyroid autoantibodies in women with infertility compared with that in healthy controls.
METHODS
Systematic searches were conducted across PubMed, Embase, Web of Science, and the Cochrane Library from inception to February 5, 2024. The inclusion criteria were women with infertility and those with autoimmune thyroid antibodies. Studies in which relevant data could not be extracted, randomized control trial reports, studies with non-original or duplicate data, and non-English articles were excluded. The main outcome was prevalence rate.
RESULTS
The worldwide pooled prevalence of thyroid autoantibody positivity was 20%. In contrast, a significantly higher TAI prevalence was noted in the population with infertility than in healthy controls (risk ratio [RR] = 1.51). Subgroup analyses indicated that TAI prevalence was higher in patients receiving both assisted reproductive technology (ART) and non-ART treatments than in healthy controls (RR = 1.37 and 3.06, respectively). TAI prevalence was also higher in the recurrent abortion and non-recurrent abortion groups of infertility than in healthy controls (RR = 1.80 and 1.39, respectively). Additionally, a higher TAI prevalence was found in the euthyroid and non-simple euthyroid groups than in the control group (RR = 2.77 and 1.43, respectively). The prevalence was significantly higher in cases of unexplained infertility, endometriosis, ovulation disorders, and fallopian tube factors among women with infertility than among the control group (RR = 1.53, 1.83, 1.42, and 2.00, respectively).
CONCLUSIONS
Thyroid autoantibodies are more prevalent in patients with infertility than in healthy controls. Given the presence of thyroid autoantibodies, screening patients with infertility is clinically important.
© 2024. The Author(s).
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