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Effect of Anti-thyroid Peroxidase Antibodies on Assisted Reproductive Technologies Outcomes: A Retrospective Cohort
Nora Nerdrum Stølan1, Pernille Fog Svendsen1,2, Anna Klajnbard1
1Department of Obstetrics and Gynecology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
Background:
Anti-thyroid peroxidase antibodies (TPOAbs) are common among women of reproductive age, especially in assisted reproductive technologies (ART). Their impact on early embryological outcomes remains unclear. Intracytoplasmic sperm injection (ICSI) has been proposed to overcome possible adverse effects of TPOAbs in the follicular fluid.
Aim:
The aim of the study was to evaluate the effect of TPOAbs on fertilisation in women undergoing in vitro fertilisation (IVF) and to compare fertilisation between IVF and ICSI in TPOAb-positive women.
Settings And Design:
The study design was a retrospective cohort study.
Materials And Methods:
Data were retrieved from institutional records. 779 women undergoing their first IVF or split cycle at Herlev Hospital between December 2019 and November 2024 were included.
Statistical Analysis Used:
Logistic regression was used to assess fertilisation and blastocyst outcomes. All models were adjusted for age, body mass index, sperm type, sperm quality and smoking status.
Results:
No significant differences were observed in fertilisation or blastocyst development between TPOAb-positive and negative women undergoing IVF. In the split group, TPOAb-positive women had higher fertilisation with ICSI than IVF; however, this difference was not significant (odds ratio [OR]: 1.66, 95% confidence interval [CI]: 0.96-2.90). Among TPOAb-negative women, ICSI was associated with a significantly higher fertilisation rate (OR: 1.50, 95% CI: 1.20-1.87), whereas the increase in blastocyst formation was not significant.
Conclusion:
Fertilisation did not differ between TPOAb-positive and TPOAb-negative women undergoing ART. Although ICSI was associated with higher fertilisation rates, this effect was observed irrespective of TPOAb status. The benefit of ICSI likely reflects technique-related advantages rather than modulation by thyroid autoimmunity. Prospective studies are warranted.
