TPO-Ab、TSH与体外受精-胚胎移植结局  

TPO-Ab AND TSH RELATED WITH IN VITRO FERTILIZATION AND EMBRYO TRANSPLANTATION

作　　者：王莉云[1] 靳隽[2] 王辉[2] 党小红[1] 

机构地区：[1]青海省人民医院生殖医学中心,青海西宁810007 [2]新乡医学院医学检验学院,河南新乡453003

出　　处：《青海医学院学报》2014年第4期227-231,共5页Journal of Qinghai Medical College

摘　　要：目的明确TPO-Ab、TSH与体外受精-胚胎移植结局的关系。方法分析体外受精-胚胎移植患者助孕周期资料。依据TPO-Ab分组,TPO-Ab阳性且甲状腺功能正常患者作为研究组,TPO-Ab阴性且甲状腺功能正常患者作为对照组;TPO-Ab阳性并TSH<2.5 u IU/m L患者作为研究组,TPO-Ab阳性并TSH≥2.5 u IU/m L患者作为对照组;TPO-Ab阴性并TSH<2.5 u IU/m L作为研究组,TPO-Ab阴性并TSH≥2.5 u IU/m L患者作为对照组。结果 TPO-Ab阳性组IVF受精率(79.76%)、优质胚胎率(46.59%)明显低于TPO-Ab阴性组IVF受精率(84.08%),优质胚胎率(54.49%)、TPO-Ab阳性组流产率(33.33%)明显高于TPO-Ab阴性组流产率(16.11%),差异均有统计学意义(P<0.05);TPO-Ab阳性且TSH<2.5组优质胚胎率(55.39%)、T4值(15.76±2.00)明显高于TPO-Ab阳性且TSH≥2.5组优质胚胎率(40.32%)、T4值(14.27±2.04),差异均有统计学意义(P<0.05);TPO-Ab阴性且TSH<2.5组优质胚胎率(58.19%)明显高于TPO-Ab阴性且TSH≥2.5组优质胚胎率(52.19%),差异有统计学意义(P<0.05);各分组间其他资料比较无统计学意义(P>0.05)。结论 TPO-Ab阳性及TSH高值对IVF-ET结局存在不利关系。此类患者在接受IVF-ET治疗前应调节甲状腺功能有利于IVF-ET结局。Objective To clarify the effects of thyroid peroxidase antibodies（TPO -Ab）and thyroid stimulating hormone（TSH） on in vitro fertilization（IVF） embryo transfer （ET） ending. Methods Patients＇ data for assisted re- production cycles of in vitro fertilization and embryo transplantation were analyzed. Based on the situation of TPO - Ab and the level of TSH, this study was divided into 6 groups ： the TPO - Ab positive and thyroid function normal as the trial group and the TPO -Ab negative and thyroid function normal as the control ;TPO -Ab positive and TSH 〈 2.5 uiu/mL as the trial group and TPO -Ab positive and TSH≥2.5 uiu/mL as the control; the TPO - Ab negative and TSH 〈 2.5 uiu/mL as the trial group and the TPO - Ab negative and TSH ≥ 2.5 uiu/mL as the control. Results IVF fertility rate and high quality embryo transplantation rate in TPO - Ab positive group were 79.76% and 46.59% respectively,lower than those in TPO - Ab negative group（84.08% and 54.49% respec- tively ） ;Abortion rate of TPO -Ab positive group was 33.33% ,obviously higher than that of TPO -Ab negative group（ 16.11% ）,and the difference was statistically significant（ P 〈 0.05 ）;High quality embryo rate（ 55.39% ） and T4 value （15.76 ± 2.00）of TPO -Ab positive with TSH 〈 2.5 uiu/mL group were higher than the TPO -Ab positive with TSH ≥2.5 uiu/mL group （ 40. 32%, 14.27 ± 2.04 ）, the difference were statistically significant （P 〈0.05） ;High quality embryo rate（58.19% ）in TPO -Ab negative with TSH 〈 2.5 uiu/mL group is signifi- cantly higher than the TPO -Ab negative with TSH ≥12.5 uiu/mL group（52.19% ） ,the difference was statistically significant （ P 〈 0.05 ）. Conclusion TPO - Ab positive and higher levels of TSH have negative effects on IVF - ET ending. Therefore, the thyroid function should be modulated before receiving IVF- ET.

关 键 词：甲状腺过氧化物酶抗体 促甲状腺素 体外受精-胚胎移植 流产 妊娠 

分 类 号：R392.69[医药卫生—免疫学]