Pathogenetic features of immunological disorders in women with thyroid peroxidase antibodies presence and their effect on infertility treatment by in vitro fertilization (IVF)

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Autoimmune thyroiditis (AIT) is the most common thyroid disease among women of fertile age. An increase of thyropercosidase antibodies (TPO-Ab) occupies one of the leading positions among other autoantibodies in patients with idiopathic infertility. Stimulation of superovulation in assisted reproductive technology (ART) programs leads to thyroid overstimulation, relative hypothyroxinemia and an increase of thyroid stimulating hormone (TSH) level in women with positive TPO-Ab carrier state, leading to a decrease in the reserve capacity of the thyroid affected by the autoimmune process. There is a large number of studies concerning the effect of autoimmune thyroid diseases on the infertility treatment outcomes in ART programs, but the results are contradictory. One of the hypotheses is that TPO-Ab affect the embryo implantation process in the uterus, based on an imbalance of cytokine production by T-helper type 1, 2, and 17, which are not easy to correct by classical hormone replacement therapy with levothyroxine. Nowadays, the immunological mechanisms of these disorders are not well investigated.

Keywords:

positive TPO-Ab carrier state

in vitro fertilization and embryos transfer

pregnancy

cytokines

implantation

Authors:

Druzhinina A.S.

Endocrinology Research Centre, Moscow, Russia

Vitiazeva I.I.

FGBU Éndokrinologicheskiĭ nauchnyĭ tsentr Minzdravsotsrazvitiia Rossiĭskoĭ Federatsii

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