Pregnancy outcomes and newborn characteristics in women with follicular fluid thyroid autoantibodies undergoing assisted reproduction

Pregnancy and newborn outcomes in assisted reproduction

  • Dr sci.med. Odjeljenje endokrinologije, Interna klinika, Klinicki centar Crne Gore
  • Prof. dr. In Vitro Fertilisation Department, Clinic for Gynecology and Obstetrics "Narodni front", Belgrade, Serbia
  • Dr Emergency Medicine Center of Montenegro, Podgorica, Montenegro
  • Ass.dr.sci.med. Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Serbia
  • Ass.dr.sci.med. Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  • Mr sci.med. In Vitro Fertilisation Department, Clinic for Gynecology and Obstetrics "Narodni front", Belgrade, Serbia
  • Prof.dr. Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, School of Medicine, University of Montenegro, Podgorica, Montenegro
  • Ass.dr.sci.med. Pediatric Intensive Care Unit, University Children’s Hospital, Belgrade, Serbia
  • Prof. dr. Department of Thyroid Gland Disease, Clinic of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia
DOI: https://doi.org/10.5937/jomb0-35243
Keywords: assisted reproductive technology, follicular fluid, pregnancy, thyroid autoimmunity

Abstract


Background: Higher levels of thyroid autoantibodies in follicular fluid (FF) of thyroid autoimmunity (TAI) positive women are strongly correlated with serum levels and may have effect on the post-implantation embryo development. Literature highlights that levothyroxine (LT4) treatment may attenuate the risk of adverse pregnancy outcomes. The aim of the study was to estimate the pregnancy and newborn outcomes in women with FF thyroid autoantibodies undergoing assisted reproductive technology (ART).

Methods: The study population included 24 women with confirmed clinical pregnancy, 8 TAI positive and 16 TAI negative women. LT4 supplementation was applied in 20.8% patients, TAI positive.

Results: Pregnancy outcomes were: twin pregnancy rate 41.7%, early miscarriage rate 8.3%, late miscarriage rate 4.2%, preterm birth rate 16,7%, term birth rate 70.8%, live birth rate 96.0%. There was significant difference in serum and in FF TgAbs (p<0.001) between the groups according to TAI, while serum fT3 was lower in the group with TAI (p=0.047). Serum fT4 was higher in LT4 treated group (p=0.005), with TAI, and newborns in this group had higher birth weight (p=0.001) and height (p=0.008). Maternal complications occurred in 23.8% of patients. No congenital malformations in newborns were noted.

Conclusions: Thyroid autoantibodies present in FF may have an effect on the post-implantation embryo development, but have no effect on further course of pregnancy. The special benefit of LT4 treatment for successful ART outcome was demonstrated for newborn anthropometric parameters.

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Published
2022/06/29
Issue
Vol. 42 No. 1 (2023): Journal of Medical Biochemistry
Section
Original paper

Copyright (c) 2022 Sanja Medenica, Eliana Garalejic, Dzihan Abazovic, Zoran Bukumiric, Stavroula A. Paschou, Biljana Arsic, Snezana Vujosevic, Bijana Medjo, Milos Zarkovic

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