Features of the immune system in women of reproductive age with infertility and autoimmune thyroid disease

The objective: to assess the features of the immune system in women of reproductive age with infertility and autoimmune thyroiditis (AIT).Material and methods.To achieve the goal, 104 women of reproductive age were examined: 57 patients with AIT (main group), 25 patients without thyroid pathology (comparison group) and 22 healthy fertile women (control group).The examination of women included a general clinical and laboratory, specific immunological examination and instrumental examination.Results. Among women with AIT, compared with patients without thyroid pathology and healthy fertile women, the frequency of elevated levels of cardiolipin class M antibodies was significantly higher (12.3%, 0% and 0%; p < 0.05); antibodies to 62-glycoprotein-1 class M (17.5%, 4% and 0%; p < 0.05); antibodies to phosphatidyl-serine class G (10.5%, 0% and 0%; p < 0.05). Elevated levels of antinuclear antibodies were detected only in 1 patient in the main study group (1.8%), while in all women in the comparison group and the control group, the concentrations of antinuclear antibodies corresponded to the normative values. Elevated levels of antiovarian antibodies were noted in 6 (10.5%) patients in the main group and were not noted in either the comparison group or the control group. However, the mean levels of antiovarian antibodies were comparable in the three groups: 5.7±3.6 U/ml, 4.6±4.1 U/ml and 4.5±3.8 U/ml respectively (p > 0.05). Elevated levels of IgM to b-hCG were significantly more frequent in women in the main group (20.0%) than in the comparison group (7.5%) and in the control group (4.5%) (p < 0.05). Elevated levels of IgG were detected in 13.3%, 10.0% and 9.1% of patients in both groups respectively (p > 0.05). Both types of immunoglobulins were detected in 10% of patients in the main group, 7.5% of women in the comparison group and 4.5% of patients control group (p > 0.05). The average IgM values for AT-β-hCG in both groups did not exceed the normative values (13.9±9.2 IU/ml, 14.8±11.3 IU/ml, 14.1±7.5 IU/ml p > 0.05), as did the average IgG levels to β-hCG (15.2±8.2 IU/ml, 13.3±11.1 IU/ml, 14.4±8.9 IU/ml; p > 0.05). In 2 patients of the main group, a combination of antibodies to P and antibodies to b-hCG was detected.Conclusions. In patients of the main study group, a significantly higher frequency of antibodies to phospholipids and cofactors (to cardiolipin 62-glycoprotein-1, phosphatidylserine), anti-ovarian antibodies and antibodies to hCG was found compared to the group of women without thyroid pathology and healthy fertile women.Keywords: infertility, autoimmune thyroiditis, organ-specific and non-organ-specific autoantibodies