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目的研究甲状腺功能正常女性中甲状腺自身抗体(ATA)、促甲状腺激素(TSH)对IVF-ET助孕治疗后妊娠结局的影响。方法回顾性分析2014年6月至2015年6月就诊于山东中医药大学第二附属医院生殖医学科行体外受精-胚胎移植(IVF-ET)助孕治疗女性,根据ATA分为ATA阳性组和ATA阴性组,再根据TSH值2.5m IU/L为界分别将两组分为两个亚组。结果 1.ATA阳性组IVF受精率(73.9%)、FT3水平(4.70±0.44)分别低于ATA阴性组IVF受精率(78.1%)、FT3水平(4.83±0.46),ATA阳性组早期流产率(38.7%)、FT4水平(16.05±1.80)明显高于ATA阴性组早期流产率(18.6%)、FT4水平(15.50±1.61),差异均有统计学意义(P<0.05)。2.ATA阳性且TSH>2.5m IU/L组获卵数(10.69±6.08)明显少于ATA阳性且TSH≤2.5m IU/L组获卵数(14.72±5.91),差异有统计学意义(P<0.05)。3.ATA阴性且TSH>2.5m IU/L组FT4水平(15.03±1.50)低于ATA阴性且TSH≤2.5m IU/L组FT4水平(15.65±1.62),差异有统计学意义(P<0.05)。结论ATA阳性会增加IVF-ET助孕治疗后流产风险,不孕女性在治疗前应常规检查ATA及甲状腺功能,尽早予以干预。
Objective To investigate the effect of thyroid autoantibodies (ATA) and thyrotropin (TSH) on the outcome of pregnancy after IVF-ET assisted treatment in women with normal thyroid function. Methods Retrospective analysis of women assisted by IVF-ET from June 2014 to June 2015 in Reproductive Medicine Hospital of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine was divided into ATA-positive group ATA negative group, then according to the TSH value of 2.5m IU / L as the boundary of the two groups were divided into two subgroups. IVF fertilization rate (73.9%) and FT3 level (4.70 ± 0.44) were lower in AATA positive group than in ATA negative group (78.1%), FT3 level (4.83 ± 0.46), ATA positive group 38.7%). FT4 level (16.05 ± 1.80) was significantly higher than that of ATA negative group (18.6%) and FT4 level (15.50 ± 1.61) respectively, with statistical significance (P <0.05). The number of oocytes (2.70 ± 6.01) in the group with TS positive and TSH> 2.5m IU / L was significantly less than that in the group with positive ATA and TSH≤2.5m IU / L (10.69 ± 6.08) (14.72 ± 5.91) P <0.05). The FT4 level (15.03 ± 1.50) in the group with TSH> 2.5m IU / L was lower than that in the group with ATA negative and TSH≤2.5m IU / L (15.65 ± 1.62), the difference was statistically significant (P <0.05 ). Conclusions ATA positive will increase the risk of miscarriage after IVF-ET assisted pregnancy. Infertile women should be routinely examined for ATA and thyroid function before treatment, and intervention should be given as soon as possible.