Thyroid peroxidase antibody in women with unexplained recurrent miscarriage: prevalence, prognostic value, and response to empirical thyroxine therapy
Fertility and Sterility, 05/24/2012
Yan J et al. – The prevalence of TPOAb–positive results in women with unexplained RM is not higher than in the general population, TPOAb–positive status does not have a prognostic value regarding the outcome of a subsequent pregnancy, and empirical thyroxine therapy in those who tested positive did not seem to improve outcome.Methods
- A total of 496 women with unexplained RM and 220 women with known diagnoses of RM who had a TPOAb test.
- Thyroxine replacement (50 μg daily during pregnancy) was begun in some patients who tested positive for thyroid peroxidase antibody, irrespective of TSH level.
- Miscarriage and live birth rates of a subsequent pregnancy.
- A total of 496 women with unexplained RM who had a TPOAb test were included in the study.
- Of these, 10.7% of subjects tested positive for TPOAb. The prevalence of TPOAb in control subjects who had a known cause for RM was 11.8%.
- The live birth rate of the first pregnancies after referral was 64%, 53%, and 58% in TPOAb–negative, TPOAb–positive with thyroxine treatment, and TPOAb–positive without treatment subjects; there was no significant difference in the outcome between any two or three groups, or between those who tested positive or negative for TPOAb.
- Among women who tested positive for TPOAb, there was no difference in the antibody titer between women with unexplained RM and those with a known cause for the pregnancy loss.
- Women who tested positive for TPOAb were significantly more likely to have TSH levels above the normal range (≥4.2 mIU/L).