Thyroglobulin Autoantibodies: Is There Any Added Value in the Detection of Thyroid Autoimmunity in Women Consulting for Fertility Treatment?

Abstract

Background: Thyroid autoimmunity (TAI) is frequent in infertile women, but to what extent thyroglobulin autoantibodies (Tg-Abs) contribute to TAI is unclear in the literature. The aims of the present study were to determine the prevalence of TAI in women consulting for fertility problems and to investigate the impact of isolated Tg-Abs, isolated thyroid peroxidase autoantibodies (TPO-Abs), and the presence of both autoantibody types on thyroid function. Furthermore, thyroid function was compared between women with and without TAI and between infertile and fertile women. Methods: A cross-sectional data analysis nested within an ongoing prospective cohort study was performed in order to determine the prevalence of TAI in unselected women consulting our tertiary referral center for reproductive medicine (CRM). The women underwent a determination of serum thyrotropin (TSH), free thyroxine (FT4), TPOAbs, and Tg-Abs. The cause of infertility, age, body-mass index (BMI), and smoking habits were recorded. Results: The prevalence of TAI was 16% (163/992). In 8% of cases, both types of autoantibodies were present, in 5% isolated positive Tg-Abs were found, and 4% had isolated positive TPO-Abs ( p = 0.025 and p = 0.003 respectively). The prevalence of TAI was significantly higher in infertile women as compared to that in fertile controls (19% vs. 13%; p = 0.047). The median serum TSH level was significantly higher in the women with TAI and with isolated positive Tg-Abs compared to that in women without TAI (1.83 [1.44] and 1.90 [0.85] vs. 1.47 [0.94] mIU/L; p <0.001 respectively). The median FT4, age, BMI, and smoking habits were comparable between the study groups. Conclusions: The prevalence of TAI was higher in infertile women as compared to fertile women consulting our CRM. Five percent of the women had isolated positive Tg-Abs and a significantly higher serum TSH compared to that in women without TAI.

Maternal Subclinical Hypothyroidism, Thyroid Autoimmunity, and the Risk of Miscarriage: A Prospective Cohort Study

“…First, thyroid autoantibodies may be considered as markers for generalized autoimmune dysfunction in the body because they have been known to be associated with an increased risk for pregnancy loss. In our previous study, we found that TgAb correlates with miscarriage rate, and Unuane et al reported that TAI is considered as one of the risk factors of infertility (23,27). Second, TAI-positive euthyroid women are more prone to develop subclinical or overt hypothyroidism during pregnancy due to hormonal imbalance, particularly in the first trimester (27), although our findings did not reveal significantly higher serum TSH levels in the women with positive TPOAb compared to the women without TPOAb.…”

Prevalence of thyroid autoimmunity and dysfunction in women with iron deficiency during early pregnancy: is it altered?

“…Whether these antigens are then only TPO, Tg, or both is also a question, we cannot answer because Tg and Tg-abs were not measured. Indeed, in a study by Unuane et al, it has been shown that in the case of TAI (when using sensitive assays), the prevalence of Tg-abs is even higher in women of reproductive ages as compared with that of TPO-abs (20).…”

Comparison of thyroglobulin and thyroid peroxidase antibodies measured by five different kits in autoimmune thyroid diseases

“…Therefore, we searched for recent reports on screening studies of TgAb and TPOAb. To avoid the influence of diseases themselves, we only considered studies done on healthy control subjects in various regions in different countries [24][25][26][27][28][29][30][31][32][33][34][35][36][37]. In healthy subjects, the incidence of positive TgAb or TPOAb is …”