Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women

Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective To study whether preconceptual thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) antibodies are associated with poor reproductive outcomes in infertile women. Design Secondary analysis of data from two multicenter, randomized, controlled trials conducted by the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Multivariable logistic regression analyses were performed to assess the association between preconceptual TSH levels and anti-TPO antibodies. Setting Not applicable. Patient(s) Serum samples from 1,468 infertile women were utilized. Intervention(s) None. Main Outcome Measure(s) Cumulative conception, clinical pregnancy, miscarriage, and live birth rates were calculated. Result(s) Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs. TSH < 2.5 mIU/L. Women with anti-TPO antibodies had similar conception rates (33.3% vs. 36.3%) but higher miscarriage rates (43.9% vs. 25.3%) and lower live birth rates (17.1% vs. 25.4%) than those without anti-TPO antibodies. Adjusted, multivariable logistic regression models confirmed elevated odds of miscarriage (odds ratio 2.17, 95% confidence interval 1.12–4.22) and lower odds of live birth (oddr ratio 0.58, 95% confidence interval 0.35–0.96) in patients with anti-TPO antibodies. Conclusion(s) In infertile women, preconceptional TSH ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, anti-TPO antibodies are associated with increased risk of miscarriage and decreased probability of live birth. Clinical Trial Registration Number PPCOS II NCT00719186; AMIGOS NCT01044862.

Original languageEnglish (US)
Pages (from-to)843-850
Number of pages8
JournalFertility and sterility
Volume108
Issue number5
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

Fingerprint

Birth Rate
Live Birth
Thyrotropin
Peroxidase
Spontaneous Abortion
Antibodies
Logistic Models
Pregnancy Rate
National Institute of Child Health and Human Development (U.S.)
Confidence Intervals
Reproductive Medicine
Randomized Controlled Trials
Odds Ratio
Regression Analysis
Outcome Assessment (Health Care)
Clinical Trials
Serum

Keywords

  • Antibodies
  • autoimmunity
  • infertility
  • pregnancy
  • spontaneous abortion
  • thyroid

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women. / Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network.

In: Fertility and sterility, Vol. 108, No. 5, 01.11.2017, p. 843-850.

Research output: Contribution to journalArticle

Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network 2017, 'Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women', Fertility and sterility, vol. 108, no. 5, pp. 843-850. https://doi.org/10.1016/j.fertnstert.2017.08.026
Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network. / Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women. In: Fertility and sterility. 2017 ; Vol. 108, No. 5. pp. 843-850.
@article{c3e2fa934cea48f088d428a636c930e3,
title = "Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women",
abstract = "Objective To study whether preconceptual thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) antibodies are associated with poor reproductive outcomes in infertile women. Design Secondary analysis of data from two multicenter, randomized, controlled trials conducted by the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Multivariable logistic regression analyses were performed to assess the association between preconceptual TSH levels and anti-TPO antibodies. Setting Not applicable. Patient(s) Serum samples from 1,468 infertile women were utilized. Intervention(s) None. Main Outcome Measure(s) Cumulative conception, clinical pregnancy, miscarriage, and live birth rates were calculated. Result(s) Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs. TSH < 2.5 mIU/L. Women with anti-TPO antibodies had similar conception rates (33.3{\%} vs. 36.3{\%}) but higher miscarriage rates (43.9{\%} vs. 25.3{\%}) and lower live birth rates (17.1{\%} vs. 25.4{\%}) than those without anti-TPO antibodies. Adjusted, multivariable logistic regression models confirmed elevated odds of miscarriage (odds ratio 2.17, 95{\%} confidence interval 1.12–4.22) and lower odds of live birth (oddr ratio 0.58, 95{\%} confidence interval 0.35–0.96) in patients with anti-TPO antibodies. Conclusion(s) In infertile women, preconceptional TSH ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, anti-TPO antibodies are associated with increased risk of miscarriage and decreased probability of live birth. Clinical Trial Registration Number PPCOS II NCT00719186; AMIGOS NCT01044862.",
keywords = "Antibodies, autoimmunity, infertility, pregnancy, spontaneous abortion, thyroid",
author = "{Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network} and Aimee Seungdamrong and Steiner, {Anne Z.} and Gracia, {Clarisa R.} and Legro, {Richard S.} and Diamond, {Michael Peter} and Christos Coutifaris and Schlaff, {William D.} and Peter Casson and Christman, {Gregory M.} and Robinson, {Randal D.} and Hao Huang and Ruben Alvero and Hansen, {Karl R.} and Susan Jin and Esther Eisenberg and Heping Zhang and Nanette Santoro",
year = "2017",
month = "11",
day = "1",
doi = "10.1016/j.fertnstert.2017.08.026",
language = "English (US)",
volume = "108",
pages = "843--850",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women

AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network

AU - Seungdamrong, Aimee

AU - Steiner, Anne Z.

AU - Gracia, Clarisa R.

AU - Legro, Richard S.

AU - Diamond, Michael Peter

AU - Coutifaris, Christos

AU - Schlaff, William D.

AU - Casson, Peter

AU - Christman, Gregory M.

AU - Robinson, Randal D.

AU - Huang, Hao

AU - Alvero, Ruben

AU - Hansen, Karl R.

AU - Jin, Susan

AU - Eisenberg, Esther

AU - Zhang, Heping

AU - Santoro, Nanette

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Objective To study whether preconceptual thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) antibodies are associated with poor reproductive outcomes in infertile women. Design Secondary analysis of data from two multicenter, randomized, controlled trials conducted by the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Multivariable logistic regression analyses were performed to assess the association between preconceptual TSH levels and anti-TPO antibodies. Setting Not applicable. Patient(s) Serum samples from 1,468 infertile women were utilized. Intervention(s) None. Main Outcome Measure(s) Cumulative conception, clinical pregnancy, miscarriage, and live birth rates were calculated. Result(s) Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs. TSH < 2.5 mIU/L. Women with anti-TPO antibodies had similar conception rates (33.3% vs. 36.3%) but higher miscarriage rates (43.9% vs. 25.3%) and lower live birth rates (17.1% vs. 25.4%) than those without anti-TPO antibodies. Adjusted, multivariable logistic regression models confirmed elevated odds of miscarriage (odds ratio 2.17, 95% confidence interval 1.12–4.22) and lower odds of live birth (oddr ratio 0.58, 95% confidence interval 0.35–0.96) in patients with anti-TPO antibodies. Conclusion(s) In infertile women, preconceptional TSH ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, anti-TPO antibodies are associated with increased risk of miscarriage and decreased probability of live birth. Clinical Trial Registration Number PPCOS II NCT00719186; AMIGOS NCT01044862.

AB - Objective To study whether preconceptual thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) antibodies are associated with poor reproductive outcomes in infertile women. Design Secondary analysis of data from two multicenter, randomized, controlled trials conducted by the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Multivariable logistic regression analyses were performed to assess the association between preconceptual TSH levels and anti-TPO antibodies. Setting Not applicable. Patient(s) Serum samples from 1,468 infertile women were utilized. Intervention(s) None. Main Outcome Measure(s) Cumulative conception, clinical pregnancy, miscarriage, and live birth rates were calculated. Result(s) Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs. TSH < 2.5 mIU/L. Women with anti-TPO antibodies had similar conception rates (33.3% vs. 36.3%) but higher miscarriage rates (43.9% vs. 25.3%) and lower live birth rates (17.1% vs. 25.4%) than those without anti-TPO antibodies. Adjusted, multivariable logistic regression models confirmed elevated odds of miscarriage (odds ratio 2.17, 95% confidence interval 1.12–4.22) and lower odds of live birth (oddr ratio 0.58, 95% confidence interval 0.35–0.96) in patients with anti-TPO antibodies. Conclusion(s) In infertile women, preconceptional TSH ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, anti-TPO antibodies are associated with increased risk of miscarriage and decreased probability of live birth. Clinical Trial Registration Number PPCOS II NCT00719186; AMIGOS NCT01044862.

KW - Antibodies

KW - autoimmunity

KW - infertility

KW - pregnancy

KW - spontaneous abortion

KW - thyroid

UR - http://www.scopus.com/inward/record.url?scp=85032815227&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032815227&partnerID=8YFLogxK

U2 - 10.1016/j.fertnstert.2017.08.026

DO - 10.1016/j.fertnstert.2017.08.026

M3 - Article

AN - SCOPUS:85032815227

VL - 108

SP - 843

EP - 850

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 5

ER -