Communications medicine · 2025
The effect of TPOAb on pregnancy outcomes among people with polycystic ovary syndrome with euthyroidism undergoing in vitro fertilization.
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Liu Jiao-Jing, Zhou Li-Yang, Geng Li-Hong, Dong Fang-Di, Fu Li-Juan, Gu Guang-Yan, Yu Na, Liu Shi-Yu, Ding Yu-Bin, Yang Hui-Jun
Аннотация
BACKGROUND: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder and a leading cause of infertility. When accompanied by anti-thyroid peroxidase antibodies (TPOAb), PCOS patients may face an increased risk of reproductive complications. However, the impact of TPOAb on assisted reproductive technology (ART) outcomes in PCOS remains unclear. Assessing the impact of TPOAb levels on embryologic and pregnancy outcomes in IVF/ICSI cycles among euthyroid PCOS patients is crucial for identifying potential risks and refining clinical management strategies to improve reproductive outcomes.
METHODS: This retrospective cohort study includes PCOS patients selected using standard diagnostic codes, strict inclusion and exclusion criteria, and propensity score matching (PSM) at a 1:4 ratio. A total of 62 TPOAb-positive PCOS patients are matched with 216 TPOAb-negative PCOS patients undergoing IVF/ICSI treatment. The primary outcomes assessed are clinical pregnancy rate and live birth rate, while secondary outcomes include other pregnancy-related outcomes and embryo quality parameters.
RESULTS: Here we show that the TPOAb-positive group has significantly higher fertilization rate, normal fertilization (two-pronuclei, 2PN) rate, and 2PN cleavage rate after PSM (all P < 0.05). However, multivariate analyses adjusting for propensity scores reveal no significant associations between TPOAb status and any embryologic indicators. Additionally, there are no statistically significant differences between the groups in pregnancy outcomes (all P > 0.05).
CONCLUSIONS: TPOAb positivity is not associated with adverse embryonic or pregnancy outcomes in euthyroid PCOS patients undergoing IVF/ICSI treatment. Therefore, the presence of TPOAb alone should not be overemphasized, nor does it warrant overtreatment in this patient population.
METHODS: This retrospective cohort study includes PCOS patients selected using standard diagnostic codes, strict inclusion and exclusion criteria, and propensity score matching (PSM) at a 1:4 ratio. A total of 62 TPOAb-positive PCOS patients are matched with 216 TPOAb-negative PCOS patients undergoing IVF/ICSI treatment. The primary outcomes assessed are clinical pregnancy rate and live birth rate, while secondary outcomes include other pregnancy-related outcomes and embryo quality parameters.
RESULTS: Here we show that the TPOAb-positive group has significantly higher fertilization rate, normal fertilization (two-pronuclei, 2PN) rate, and 2PN cleavage rate after PSM (all P < 0.05). However, multivariate analyses adjusting for propensity scores reveal no significant associations between TPOAb status and any embryologic indicators. Additionally, there are no statistically significant differences between the groups in pregnancy outcomes (all P > 0.05).
CONCLUSIONS: TPOAb positivity is not associated with adverse embryonic or pregnancy outcomes in euthyroid PCOS patients undergoing IVF/ICSI treatment. Therefore, the presence of TPOAb alone should not be overemphasized, nor does it warrant overtreatment in this patient population.