Effect of antithyroid antibodies on women with recurrent miscarriage: A meta‐analysis

Abstract

Problem The effect of thyroid autoimmunity (TAI) on the prevalence of recurrent miscarriage (RM) is highly debatable. No meta‐analysis has been published in the past decade to investigate the impact of TAI on women with RM. Method of Study Systemic literature search was conducted on PubMed, Embase, Cochrane, and Web of Science databases. English language literatures published between 1993 and 2019 were selected. We assessed the relationship between the prevalence of RM and thyroid peroxidase antibodies (TPO‐Ab) or antithyroid antibodies (ATA) and evaluated the thyroid‐stimulating hormone (TSH) level in TPO‐Ab‐positive women with RM. We also observed the treatment effect with levothyroxine (LT4) for RM. Review Manager 5.3 software was used to obtain the pooled odds ratios (OR). Results Analysis of 22 eligible studies revealed significant association between TPO‐Ab and the prevalence of RM (OR = 1.85; 95% CI, 1.38 to 2.49; P < .001)(n ≥ 3), (OR = 1.82; 95% CI, 1.13 to 2.92; P = .01) (n ≥ 3). Women with ATA + had higher risk of RM (OR = 2.36; 95% CI, 1.71 to 3.25; P < .00001)(n ≥ 3), (OR = 2.34; 95% CI, 1.70 to 3.22; P < .00001)(n ≥ 2). RM women with TPO‐Ab had higher TSH level when compared with those negative for TPO‐Ab (random‐effect SMD = 0.60; 95% CI, 0.31 to 0.90; P < .0001). We also found beneficial effects of LT4 supplementation on the outcome of live birth rate (LBR) among pregnant women with TPO‐Ab (OR = 3.04; 95% CI, 0.69 to 13.36; P = .14). Conclusion The presence of serum antithyroid antibodies does harms to women and can even lead to recurrent miscarriage; LT4 treatment may have beneficial to RM women.

IVF/ICSI outcomes of euthyroid infertile women with TAI: does treating with aspirin plus prednisone matter?

“…Furthermore, a 2020 meta-analysis of 17 studies pinpointed a statistically signi cant association between RPL and TAI (odds ratio 1.94; 95% CI, 1.43-2.64). The statistical signi cance and magnitude of the results remained unchanged following sensitivity analyses [42], similarly to the ndings in our previous work [43]. Up to now, for euthyroid infertile women with unexplained infertility, PCOS, or RPL, little evidence exists concerning the effect of replacement therapy of P+A.…”

IVF/ICSI Outcomes of Euthyroid Infertile Women With TAI: Aspirin Plus Prednisone Treatment, Does It Matter?

“…The weak correlation of TAI and IVF reproductive outcomes of general infertile population possibly partially explained the negative results of our study. Furthermore, a 2020 meta-analysis of seventeen studies pinpointed a statistically signi cant association between RPL and TAI (odds ratio 1.94; 95% CI, 1.43-2.64) and the statistical signi cance and magnitude of the results remained unchanged following sensitivity analyses [43], similar to the nding of our previous investigation [44]. As for euthyroid infertile women with unexplained infertility, PCOS or RPL, little evidence existed concerning the effect of replacement therapy of A plus P in those speci c women.…”

An Overview of Autoimmunity in Implantation Failure: A Literature Review

“…The pathophysiological role of ATA in pregnancy loss is based on two working hypotheses. Lifted thyroid antibodies can lead directly to pregnancy loss through biological interaction between hormones and antibodies [33]. Instead of the actual cause of pregnancy loss, ATAs may also be secondary to autoimmune diseases.…”