Evaluation of antithyroid antibodies and interferon gamma levels in euthyroid women with primary idiopathic infertility.

Primary idiopathic infertility remains challenging due to overlooked subclinical immunological factors. The purpose of this study was to examine the effects of interferon-gamma (IFN-γ) levels and Anti-Thyroid Peroxidase (Anti-TPO) antibodies on the reproductive outcomes of euthyroid women. The study included 90 participants (60 patients,30 controls). A comprehensive hormonal profile, including AMH, TSH, FSH, LH, prolactin, and estradiol, was assessed in all participants to ensure normal endocrine function. However, serum Anti-TPO levels exhibited a statistically significant elevation in the infertile group compared to the controls (P = 0.0002). According to AMH (r = -0.58), correlation analysis showed a strong negative relationship between Anti-TPO titers and ovarian reserve. Additionally, multiple binary logistic regression identified Anti-TPO as a strong independent predictor of primary idiopathic infertility. Furthermore, receiver operating characteristic (ROC) curve analysis demonstrated that Anti-TPO exhibits a good diagnostic accuracy with an area under the curve (AUC) of 0.759. These findings indicate that subclinical thyroid autoimmunity is closely associated with a decreased ovarian reserve despite normal TSH levels. In order to better identify individuals who may benefit from early immunomodulatory therapy, the research recommends that Anti-TPO antibody screening be incorporated into the routine diagnostic evaluation for idiopathic infertility.