IVF in infertile women with different forms of thyroid pathology

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INTRODUCTION

Thyroid disfunction is the most frequent pathology of female endocrine system. Any thyroid disorders may cause disorders of female reproductive system and result in abnormal changes in fetal development during pregnancy.

THE OBJECTIVE

Is comparative assessment of influence of chronic autoimmune thyroiditis and other thyroid disorders upon condition of ovarian reserve, course of induced process of oogenesis and early embryogenesis, clinical pregnancy rate after embryo transfer, rate of early fetal loss.

MATERIAL AND METHODS

Among women under 40 years old who have autoimmune thyroiditis (n=47) and other thyroid disorders (n=201), the following was analyzed: condition of ovarian reserve (by assessing the rate of anti-Mullerian Hormone and basal number of antral follicles); cancellation rate of embryo transfer due to disturbance of induced oogenesis and early embryogenesis; clinical pregnancy rate after embryo transfer and gestational loss rate in the first trimester of pregnancy.

RESULTS

With preparatory treatment the achievement of stable euthyroid state (confirmed by THS rate) among infertile women with any thyroid disorders except autoimmune thyroiditis provided treatment results that are comparable with the observed reproductive outcome when using IVF in the general female population of the same age. In comparison with women having other thyroid disorders, among the patients with autoimmune thyroiditis there was observed a significant increase in the number of patients with a considerable reduction in ovarian reserve, increase in the embryo transfer cancellation rate due to defective embryogenesis and increase in the rate of early gestational loss.

CONCLUSIONS

Taking into consideration the expected deterioration of reproductive outcome among infertile patients with autoimmune thyroiditis, it is advisable to warn them about the likely need for more IVF attempts which (despite its decreased effectiveness in comparison with the results of treatment of women with other thyroid disorders) still provides the opportunity of pregnancy of women who suffer from this disease.

Keywords:

infertility

IVF

thyroid

autoimmune thyroiditis

thyroid pathology

Authors:

Krasnopol’skaya K.V.

Moscow Regional Scientific Research Institute of Obstetrics and Gynecology;
M.F. Vladimirsky Moscow Regional Clinical Research Institute;
Prior Reproductive Health Clinic

ORCID: 0000-0002-1275-9220

Burumkulova F.F.

Moscow Regional Scientific Research Institute of Obstetrics and Gynecology

ORCID: 0000-0001-9943-0964

Sokolova E.A.

Vishnevsky National Medical Research Center of Surgery

ORCID: 0000-0002-5667-7833

Isakova K.M.

State budgetary institution of health care Moscow Region «Moscow Regional Scientific Research Institute of Obstetrics and Gynecology»

Gutueva Ch.G.

State budgetary institution of health care Moscow Region «Moscow Regional Scientific Research Institute of Obstetrics and Gynecology»

Received:

30.10.2019

Accepted:

23.01.2020

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