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亚临床甲状腺功能减退对辅助生殖妊娠结局的影响 被引量：11

Effects of subclinical hypothyroidism on pregnancy outcomes of assisted reproductive technology
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摘要 目的探讨亚临床甲状腺功能减退(subclinical hypothyroidism,SCH)对辅助生殖妊娠结局的影响。方法回顾性分析2010年2月至2011年2月在中南大学湘雅医院生殖医学中心接受体外受精-胚胎移植/卵胞浆内单精子显微注射(IVF-ET/ICSI)治疗患者的资料,其中82名亚临床甲减患者列入研究组,398名甲状腺功能正常者列入对照组,比较两组患者的各实验室及临床指标,分析亚临床甲减对辅助生殖妊娠结局的影响。结果(1)两组患者的一般情况比较无统计学差异。(2)两组患者的IVF-ET/ICSI正常受精率、卵裂率、优质胚胎率、种植率、临床妊娠率、流产率、卵巢过度刺激综合征(OHSS)发生率、平均单胎分娩总孕天数比较均无统计学差异(P>0.05);虽未达到统计学差异,但研究组的流产率、OHSS发生率高于对照组,分别为24.24%vs.15%、14.63%vs.10.1%;其中研究组的生化妊娠率显著高于对照组(11.8%vs.4.4%)(P<0.05),单胎新生儿平均出生体重明显低于对照组[(3,147.6±79.6)g vs.(3,224.9±56.5)g](P<0.05)。结论亚临床甲减患者行IVF-ET/ICSI治疗生化妊娠率、低出生体重儿发生率明显增高,流产率、OHSS发生率呈上升趋势。因此需对亚临床甲减患者IVF-ET/ICSI治疗过程及孕期进行严密监测,预防促排卵并发症及不良妊娠结局的发生。 Objective： To explore the effect of subclinical hypothyroidism（SCH）on pregnancy outcome in infertile patients undergone assisted reproductive technology. Methods： The data of 480 patients undergone in vitro fertilization-embryo transfer/intracytoplasmic sperm injection（IVF-ET/ICSI）from February 2010 to February 2011 in the reproductive medicine center of Xiangya Hospital were retrospectively analyzed. The IVF/ICSI outcomes were compared between the patients with subclinical hypothyroidism （study group, n = 82） and euthyroid patients （control group, n = 398）. The influence of SCH on pregnancy outcome was analyzed. Results： （1）There was no significant difference in patient characteristics between the two groups; （2） The fertilization rate, cleavage rate, high quality embryo rate, implantation rate, clinical pregnancy rate, miscarriage rate, ovarian hyperstimulation syndrome（OHSS）rate, and gestational age of singleton births were not significantly different between the two groups. However,the miscarriage rate（24.24% vs. 15%） and OHSS rate（14.63% vs. 10. l%）in the study group were higher than those in the control group. In the study group, the biochemical pregnancy rate was significantly higher and the singleton birth weight was significantly lower compared with those in the control group（P〈0.05）. Conclusions： The biochemical pregnancy rate and low birth weight rate are significantly higher in SCH patients undergone IVFET/ICSI. We should pay more attention to patients with SCH during controlledovarian hyperstimulation（COH）to prevent complication of COH and adverse outcome of IVF-ET/ICSI.
作者 巴林林 刘冬娥 李玉梅 覃茜 李艳萍 刘能辉
机构地区 中南大学湘雅医院生殖中心
出处 《生殖医学杂志》 CAS 2013年第12期905-909,共5页 Journal of Reproductive Medicine
关键词 亚临床甲状腺功能减退 妊娠结局 体外受精-胚胎移植 卵胞浆内单精子注射 Subclinical hypothyroidism Pregnancy outcome IVF-ET/ICSI
分类号 R [医药卫生]
  • 相关文献

参考文献19

  • 1Abalovich M, Amino N, Barbour LA, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline [J]. Clin Endoerinol Metab, 2007,92 (8 Suppl) : S1-47.
  • 2Aghajanova L, Lindeberg M, Carlsson IB, et al. Receptors for thyroid-stimulating hormone and thyroid hormones in human ovarian tissue [ J/OL]. Reprod Biomed Online, 2009,18 ( 3 ) 337-347.
  • 3吴洁.甲状腺功能与女性生殖[J].生殖医学杂志,2012,21(2):176-179. 被引量：7
  • 4Bohnet HG, K Fiedler, Leidenberger FA. Subclinical hypothyroidism and infertility[J]. Lancet, 1981,2 : 1278.
  • 5Arojoki M,Jokimaa V, Juuti A, et al. Hypothyroidism among infertile women in Finland[J]. Gynecol Endocrinol, 2000,14 : 127-131.
  • 6Simon C, Landeras J, Zuzuarregui J L, et al. Early pregnancy losses in in vitro fertilization and oocyte donation[J]. Fertil Steril, 1999,72 : 1061-1065.
  • 7Oki N, Matsuo H, Nakag0 S, et al. Effects of 3, 5, 3 '- triiodothyronine on the invasive potential and the expression of integrins and matrix metalloproteinases in cultured earlyplacental extravillous trophoblasts [ J ]. Clin Endocrinol Metab, 2004,89 : 5213-5221.
  • 8Laoag-Fernandez J B, Matsuo H, Murakoshi H, et al. 3,5,3 ' Triiodothyronine down-regulates Fas and Fas ligand expression and suppresses caspase-3 and poly (adenosine 5 '- diphosphate-ribose) polymerase cleavage and apoptosis in early placental extravillous trophoblasts in vitro [J]. Clin Endocrinol Metab, 2004,89 : 4069-4077.
  • 9Vaquero E, Lazzarin N, Caserta D, et al. Diagnostic evaluation of women experiencing repeated in vitro fertilization failure [J]. Eur J Obstet Gynecol Reprod Biol,2006,125:79-84.
  • 10Cavagna M, Mantese JC. Biomarkers of endometrial reeeptivity-a review[J]. Placenta,2003,24(Suppl B) :S39-47.

二级参考文献38

  • 1Poppe K,Velkeniers B.Female infertility and the thyroid.Best Pract Res Clin Endocrinol Metab,2004,18(2):153-65.
  • 2Stockigt JR.Case finding and screening strategies forthyroid dysfunction.Clin Chim Acta,2002,315(1-2):111-24.
  • 3Benhadi N,Wiersinga WM,Reitsma JB,et al.Ethnicdifferences in TSH but not in free T4 concentrations orTPO antibodies during pregnancy.Clin Endocrinol,2007,66(6):765-70.
  • 4Hekimsoy Z,Kafesciler S,GülüF,et al.The prevalenceof hyperprolactinaemia in overt and subclinicalhypothyroidism.Endocr J,2010,57(12):1011-5.
  • 5Hapon MB,Motta1 AB,Ezquer M,et al.Hypothyroid-ism prolongs corpus luteum function in the pregnant rat.Reproduction,2007,133(1):197-205.
  • 6Dittrich R,Beckmann MW,Oppelt PG,et al.Thyroidhormone receptors and reproduction.J Reprod Immunol,2011,90(1):58-66.
  • 7Saiko AA,Ahmed AA,Takeshi M.Thyroid hormonesynergizes with follicle stimulating hormone to inhibitapoptosis in porcine granulosa cells selectively fromsmall follicles.Kobe J Med Sci,2003,49(5):107-16.
  • 8Oki N,Hiroya M,Nakago S,et al.Effects of 3,5,3-Triiodothyronine on the invasive potential and the ex-pression of integrins and matrix metalloproteinases incultured early placental extravillous trophoblasts.J ClinEndocrinol Metab,2004,89(10):5213-21.
  • 9Laoag-Fernandez JB,Matsuo H,Murakoshi H,et al.3,5,3-triiodothyronine down-regulates Fas and Fas ligand ex-pression and suppresses caspase-3 and Poly(adenosine5-diphosphate-ribose)polymerase cleavage andApoptosis in early placental extravillous trophoblasts invitro.J Clin Endocrinol Metabol,2004,89(8):4069-77.
  • 10Baker VL,Rone HM,Pasta DJ,et al.Correlation of thyroidstimulating hormone(TSH)level with pregnancy out-come in women undergoing in vitro fertilization.Am JObstet Gynecol,2006,194(6):1668-75.

共引文献28

同被引文献90

  • 1Berbel P,Mestre JL,Santamaria A,et al.Delayed neurobehavioral development in children born to pregnant women with mild hypothyroxinemia during the first month of gestation:the importance of early iodine supplementation[J].Thyriod,2009,19:511-519.
  • 2Thangaratinam S,Tan A,Knox E,et al.Association between thyroid autoantibodies and miscarriage and preterm birth:meta-analysis of evidence[J].BMJ,2011,342:d2616.
  • 3Abalovich M,Amino N,Barbour LA,et al.Management of thyroid dysfunction during pregnancy And postpartum:an Endocrine Society Clinical Practice Guideline[J].J Clin Endocrinol Meta,2007,92:1-47.
  • 4中华医学会内分泌学分会,中华医学会围产医学分会.妊娠和产后甲状腺疾病防治指南[J].中华围产医学杂志,2012,15:385-403.
  • 5Wang S,Teng WP,Li JX,et al.Effects of maternal subclinical hypothyroidism on obstetrical outcomes during early pregnancy[J].J Endocrinol Invest,2012,35:322-325.
  • 6Nelson DB,Casey BM,McIntire DD,et al.Subsequent pregnancy outcomes in women previously diagnosed with subclinical hypothyroidism[J].Am J Perinatol,2014,31:77-84.
  • 7Benhadi N,Wiersinga WM,Reitsma JB,et al.Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage,fetal or neonatal death[J].Eur J Endocrinol,2009,160:985-991.
  • 8Sahu MT,Das V,Mittal S,et al.Overt and subclinical thyroid dysfunction among Indian pregnant women and its effecton maternal and fetal outcome[J].Arch Gynecol Obstet,2010,281:215-220.
  • 9Traub-Weidinger T,Graf S,Beheshti M,et al.Coronary vasoreactivity in subjects with thyroid autoimmunity and subclinical hypo-thyroidism before and after supplementation with thyroxine[J].Thyroid,2012,22:245-251.
  • 10Yilmaz H,Ertugrul,Ertugˇrul B,et al.Mean platelet volume in patients with subclinical hypothyroidism[J].Platelets,2011,22:143-147.

引证文献11

二级引证文献54

生殖医学杂志
2013年 第12期

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