Horm Metab Res 2018; 50(07): 537-542
DOI: 10.1055/a-0637-9430
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Thyroid Autoantibodies do not Impair the Ovarian Reserve in Euthyroid Infertile Women: A Cross-Sectional Study

Satoko Osuka
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Akira Iwase
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
2   Department of Maternal and Perinatal Medicine, Nagoya University Hospital, Nagoya, Japan
,
Maki Goto
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Sachiko Takikawa
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Tomoko Nakamura
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Tomohiko Murase
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Nao Kato
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Bayasula,
Tomomi Kotani
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Fumitaka Kikkawa
1   Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
› Author Affiliations
Further Information

Publication History

received 01 February 2018

accepted 22 May 2018

Publication Date:
10 July 2018 (online)

Abstract

Patients with primary ovarian insufficiency (POI) have a high prevalence of thyroid autoimmune disorders. However, the extent of the contribution of thyroid autoantibodies or elevated thyroid-stimulating hormone (TSH) levels to decreased ovarian reserve is unclear. Therefore, we evaluated the serum levels of anti-Müllerian hormone (AMH) and thyroid autoantibodies [antithyroperoxidase antibody (TPOAb), and antithyroglobulin antibody (TgAb)] in euthyroid infertile women. One hundred and fifty-three women with normal menstrual cycles were recruited for this retrospective study. Serum levels of AMH were compared between patients with positive and negative thyroid autoantibodies. The correlation between serum levels of AMH and each thyroid autoantibody was also evaluated. Participants were observed to be either TPOAb or TgAb positive (n=27), only TPOAb positive (n=8), only TgAb positive (n=7), TPOAb and TgAb positive (double positive; n=12), and TPOAb and TgAb negative (double negative; n=126). No significant differences were found in serum AMH levels between the TPOAb- or TgAb-positive women and the antibody-double negative women. Serum AMH levels did not show a significant correlation with the concentration of TgAb or TPOAb. On the other hand, serum AMH levels negatively correlated with TSH levels in patients who were either positive for TPOAb or TgAb. Thyroid autoantibodies are not likely to influence ovarian reserve in euthyroid women whose TSH levels fall within the normal range although elevated TSH levels may be involved in the decline of serum AMH levels.

 
  • References

  • 1 Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol 1986; 67: 604-606
  • 2 Goswami D, Conway GS. Premature ovarian failure. Hum Reprod Update 2005; 11: 391-410
  • 3 Alper MM, Garner PR. Premature ovarian failure: Its relationship to autoimmune disease. Obstet Gynecol 1985; 66: 27-30
  • 4 de Moraes Ruehsen M, Blizzard RM, Garcia-Bunuel R, Jones GS. Autoimmunity and ovarian failure. Am J Obstet Gynecol 1972; 112: 693-703
  • 5 Nelson LM. Clinical practice. Primary ovarian insufficiency. N Engl J Med 2009; 360: 606-614
  • 6 Visser JA, Schipper I, Laven JS, Themmen AP. Anti-Mullerian hormone: An ovarian reserve marker in primary ovarian insufficiency. Nat Rev Endocrinol 2012; 8: 331-341
  • 7 Seifer DB, Baker VL, Leader B. Age-specific serum anti-Mullerian hormone values for 17,120 women presenting to fertility centers within the United States. Fertil Steril 2011; 95: 747-750
  • 8 Tal R, Seifer DB. Ovarian reserve testing: A user's guide. Am J Obstet Gynecol 2017; 217: 129-140
  • 9 Tal R, Tal O, Seifer BJ, Seifer DB. Antimullerian hormone as predictor of implantation and clinical pregnancy after assisted conception: A systematic review and meta-analysis. Fertil Steril 2015; 103: 119-130 e3
  • 10 Hazout A, Bouchard P, Seifer DB, Aussage P, Junca AM, Cohen-Bacrie P. Serum antimullerian hormone/mullerian-inhibiting substance appears to be a more discriminatory marker of assisted reproductive technology outcome than follicle-stimulating hormone, inhibin B, or estradiol. Fertil Steril 2004; 82: 1323-1329
  • 11 Tal R, Seifer DB, Khanimov M, Malter HE, Grazi RV, Leader B. Characterization of women with elevated antimullerian hormone levels (AMH): Correlation of AMH with polycystic ovarian syndrome phenotypes and assisted reproductive technology outcomes. Am J Obstet Gynecol 2014; 211: 59 e1-e8
  • 12 Kato N, Iwase A, Sugita A, Goto M, Nakahara T, Nakamura T, Kondo M, Osuka S, Mori M, Saito A, Kikkawa F. Anti-Mullerian hormone as a possible predictor of fecundability in subfertile women over 38 years: A retrospective cohort study. Gynecol Endocrinol 2015; 31: 22-25
  • 13 Iwase A, Nakamura T, Nakahara T, Goto M, Kikkawa F. Assessment of ovarian reserve using anti-Mullerian hormone levels in benign gynecologic conditions and surgical interventions: A systematic narrative review. Reprod Biol Endocrinol 2014; 12: 125
  • 14 Iwase A, Nakamura T, Nakahara T, Goto M, Kikkawa F. Anti-mullerian hormone and assessment of ovarian reserve after ovarian toxic treatment: A systematic narrative review. Reprod Sci 2014; 22: 519-526
  • 15 Iwase A, Hirokawa W, Goto M, Takikawa S, Nagatomo Y, Nakahara T, Manabe S, Kikkawa F. Serum anti-Mullerian hormone level is a useful marker for evaluating the impact of laparoscopic cystectomy on ovarian reserve. Fertil Steril 2010; 94: 2846-2849
  • 16 Knauff EA, Eijkemans MJ, Lambalk CB, ten Kate-Booij MJ, Hoek A, Beerendonk CC, Laven JS, Goverde AJ, Broekmans FJ, Themmen AP, de Jong FH, Fauser BC. Dutch Premature Ovarian Failure Consortium. Anti-Mullerian hormone, inhibin B, and antral follicle count in young women with ovarian failure. J Clin Endocrinol Metab 2010; 95: 465
  • 17 Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25
  • 18 Saito A, Iwase A, Nakamura T, Osuka S. Bayasula Murase T, Kato N, Ishida C, Takikawa S, Goto M, Kikkawa F. Involvement of mesosalpinx in endometrioma is a possible risk factor for decrease of ovarian reserve after cystectomy: A retrospective cohort study. Reprod Biol Endocrinol 2016; 14: 72
  • 19 De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, Eastman CJ, Lazarus JH, Luton D, Mandel SJ, Mestman J, Rovet J, Sullivan S. Management of thyroid dysfunction during pregnancy and postpartum: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012; 97: 2543-2565
  • 20 Sen A, Kushnir VA, Barad DH, Gleicher N. Endocrine autoimmune diseases and female infertility. Nat Rev Endocrinol 2014; 10: 37-50
  • 21 Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002; 87: 489-499
  • 22 Goswami R, Marwaha RK, Goswami D, Gupta N, Ray D, Tomar N, Singh S. Prevalence of thyroid autoimmunity in sporadic idiopathic hypoparathyroidism in comparison to type 1 diabetes and premature ovarian failure. J Clin Endocrinol Metab 2006; 91: 4256-4259
  • 23 Magri F, Schena L, Capelli V, Gaiti M, Zerbini F, Brambilla E, Rotondi M, De Amici M, Spinillo A, Nappi RE, Chiovato L. Anti-Mullerian hormone as a predictor of ovarian reserve in ART protocols: The hidden role of thyroid autoimmunity. Reprod Biol Endocrinol 2015; 13: 106
  • 24 Monteleone P, Parrini D, Faviana P, Carletti E, Casarosa E, Uccelli A, Cela V, Genazzani AR, Artini PG. Female infertility related to thyroid autoimmunity: The ovarian follicle hypothesis. Am J Reprod Immunol 2011; 66: 108-114
  • 25 Polyzos NP, Sakkas E, Vaiarelli A, Poppe K, Camus M, Tournaye H. Thyroid autoimmunity, hypothyroidism and ovarian reserve: A cross-sectional study of 5000 women based on age-specific AMH values. Hum Reprod 2015; 30: 1690-1696
  • 26 Weghofer A, Himaya E, Kushnir VA, Barad DH, Gleicher N. The impact of thyroid function and thyroid autoimmunity on embryo quality in women with low functional ovarian reserve: A case-control study. Reprod Biol Endocrinol 2015; 13: 43
  • 27 Saglam F, Onal ED, Ersoy R, Koca C, Ergin M, Erel O, Cakir B. Anti-Mullerian hormone as a marker of premature ovarian aging in autoimmune thyroid disease. Gynecol Endocrinol 2015; 31: 165-168
  • 28 Kelsey TW, Wright P, Nelson SM, Anderson RA, Wallace WH. A validated model of serum anti-mullerian hormone from conception to menopause. PloS One 2011; 6: e22024
  • 29 Kuroda K, Uchida T, Nagai S, Ozaki R, Yamaguchi T, Sato Y, Brosens JJ, Takeda S. Elevated serum thyroid-stimulating hormone is associated with decreased anti-Mullerian hormone in infertile women of reproductive age. J Assist Reprod Genet 2015; 32: 243-247
  • 30 Weghofer A, Barad DH, Darmon S, Kushnir VA, Gleicher N. What affects functional ovarian reserve, thyroid function or thyroid autoimmunity?. Reprod Biol Endocrinol 2016; 14: 26
  • 31 Erol O, Parlak M, Ellidag HY, Parlak AE, Derbent AU, Eren E, Yılmaz N. Serum anti-Mullerian hormone levels in euthyroid adolescent girls with Hashimoto's thyroiditis: Relationship to antioxidant status. Eur J Obstet Gynecol Reprod Biol 2016; 203: 204-209