The impact of thyroid autoimmunity on IVF/ICSI outcome: a systematic review and meta-analysis

The objective of this study was to define the relation between TAI per se and the outcome of in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycles. SEARCH METHODS A systematic literature review and meta-analysis were conducted. A Medline search was performed to identify all the comparative studies published from January 1990 to November 2015 in the English language literature on IVF/ICSI outcome in women with and without TAI, using combinations of the medical subject heading terms ‘thyroid autoimmunity’, ‘thyroid autoantibodies’, ‘IVF’, ‘ICSI’, ‘pregnancy’, ‘miscarriage’ and ‘delivery’. The primary outcome was live birth rate (LBR). Our secondary outcomes were number of oocytes retrieved (NOR), fertilisation rate (FR), implantation rate (IR), clinical pregnancy rate (CPR) and miscarriage rate (MR). We also extracted data on mean age and basal serum concentrations of thyroid stimulating hormone (TSH) and performed a meta-regression analysis to assess the effect of these two covariates on CPR and MR. OUTCOMES We selected 12 studies for the meta-analysis. Six of the included studies were prospective cohort studies, and six were retrospective cohort studies. Compared with women with negative TAI, women with positive TAI had a lower LBR (odds ratio (OR) 0.73; 95% confidence interval (CI) [0.54–0.99]; P = 0.04; 9 studies; 4396 women; I2 = 41%), a higher MR (OR 1.44...
Source: Human Reproduction Update - Category: OBGYN Authors: Tags: Review Source Type: research