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不孕症和辅助生殖技术中的自身免疫甲状腺疾病:一篇综述
Maria Inês Pires1, Ana Margarida Póvoa2,3, Sandra Silva-Soares2,3
1Faculty of Medicine, Universidade do Porto, Porto, Portugal.
Porto biomedical journal
|November 25, 2025
概括
自身免疫性甲状腺疾病 (ATD) 影响生育能力和辅助生殖技术 (ART) 的结果. 需要对ATD和亚临床甲状腺功能低下症 (SCH) 进行标准化查和治疗,以改善妊娠成功.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 免疫学 免疫学 免疫学
- 内分泌学 在内分泌学.
背景情况:
- 自身免疫性甲状腺疾病 (ATD) 是生殖年龄女性最常见的自身免疫性疾病.
- ATD与不孕症和辅助生殖技术 (ART) 的较差结果有关.
- 亚临床甲状腺功能低下症 (SCH) 通常伴随着ATD,使管理复杂化.
研究的目的:
- 审查ATD对不孕症和ART结果的影响.
- 检查目前在生育年龄妇女中对ATD的查和治疗策略.
- 确定对标准化临床管理的需求.
主要方法:
- 关于ATD,不孕症和ART的现有证据的文献综述.
- 对目前的TSH值和SCH治疗建议的分析.
- 在ART中对免疫调节疗法的评估.
主要成果:
- 在生育中SCH治疗的TSH值有所不同 (2.54.0mIU/L),导致临床实践不一致.
- 利沃甲氧氨酸是TSH>4.0mIU/L的标准,但其在这个值以下的益处仍在争论中.
- 免疫调节疗法如葡萄糖皮质类药物和IVIg对ART结局的有效性尚不确定.
结论:
- 在接受生育治疗的妇女中,对ATD的标准化诊断标准非常需要.
- 需要标准化治疗干预措施来优化ATD阳性女性的生育能力和ART结果,特别是那些患有SCH的女性.
- 需要进一步的研究,以澄清在较低的TSH水平和免疫调节剂的作用中使用levothyroxine的好处.
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