Low ovarian reserve associated with thyroid autoimmunity

Idiopathic low ovarian reserve was linked with thyroid peroxidase antibody positivity among Chinese women, according to researchers in Taiwan.

“Thyroid autoimmunity, with a prevalence varying between 10% to 20% of women of childbearing age, has been attracting more and more attention because of its potential adverse effect on human reproduction,” Chien-Wen Chen, MD, of the department of obstetrics and gynecology at Shuang Ho Hospital, Taipei Medical University, Taiwan, and colleagues wrote.

“The undetermined relationship between [thyroid autoimmunity] and ovarian function leads to discrepant interpretations and managements for women with [thyroid autoimmunity] between reproductive endocrinologists, medical endocrinologists and immunologists,” they wrote.

The researchers performed a cross-sectional study of 1,044 women who were treated at a fertility clinic between October 2013 and March 2016. Chen and colleagues compared thyroid-stimulating hormone levels, the prevalence of positive thyroid peroxidase antibody and positive thyroglobulin antibody across groups of patients with high, normal and low ovarian reserve.

Overall, TSH levels, as well as thyroid peroxidase antibody and thyroglobulin antibody positivity, were similar in patients with variable ovarian reserve, the researchers reported. However, after Chen and colleagues excluded patients with known causes of compromised ovarian reserve, only thyroid peroxidase antibody positivity differed in patients with high (10.3%; P = .012), normal (14%) and low (22.7%) ovarian reserve.

There was no significant correlation between thyroid peroxidase antibody levels and anti-Müllerian hormone levels. In a subgroup of interfile women, thyroid peroxidase antibody positivity was linked with low ovarian reserve in unexplained infertility in all levels of ovarian reserve (high, 9.5%; normal, 15.7%; low, 28.6%; P = .020).

 “Our findings … suggest a detrimental influence of [thyroid peroxidase antibody] positivity instead of [thyroid peroxidase antibody] levels on ovarian reserve,” the researchers wrote. – by Andy Polhamus

Disclosures: The authors report no relevant financial disclosures.