Association between thyroid-associated antibodies and ovarian reserve in infertile women: a clinical study of 526 cases

Objective To compare the positive rate of thyroid autoantibodies in infertile women with different ovarian reserve function, and investigate the immune factors of diminished ovarian reserve. Methods A cross-sectional study was conducted on infertile women admitted to Department of Reproductive Medicine of Beijing Gynaecology and Obstetrics Hospital from June to December, 2020. The levels of anti-Müllerian hormone (AMH), thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) were detected in the 526 enrolled infertile patients. According to their AMH level, they were divided into normal ovarian reserve group and diminished ovarian reserve group. After they were stratified according to their age, the differences of TSH, TGAb and TPOAb levels were compared in the different age groups to analyze the related factors for diminished ovarian reserve. Results Univariate analysis showed that the diminished ovarian reserve group had significantly higher positive rates of TPOAb (18.8% vs 11.1%, P=0.024) and TGAb (18.8% vs 8.0%, P=0.001) than the normal ovarian reserve group. Multivariate logistic regression analysis indicated that age and TGAb positivity were related to diminished ovarian reserve [OR=1.083(95%CI: 1.021~1.150), P=0.008; OR=1.159(95%CI: 1.034~1.301), P=0.011]. Subgroup analysis suggested that the positive TGAb and TPOAb were significantly correlated with AMH level in the 36-~40-year-old group (P < 0.05). Conclusion The infertile women with diminished ovarian reserve have higher TGAb and TPOAb levels, and the diminishment in those aged 36~40 years might be related to the positive TGAb and TPOAb.