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Glucocorticoid supplementation improves reproductive outcomes in infertile women with antithyroid autoimmunity undergoing ART: A meta-analysis

Medicine (Baltimore), 2021-04, Vol.100 (16), p.e25554-e25554 [Peer Reviewed Journal]

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. ;Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. 2021 ;ISSN: 0025-7974 ;EISSN: 1536-5964 ;DOI: 10.1097/MD.0000000000025554 ;PMID: 33879707

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  • Title:
    Glucocorticoid supplementation improves reproductive outcomes in infertile women with antithyroid autoimmunity undergoing ART: A meta-analysis
  • Author: Zhou, Guangqin ; Zhou, Meiying ; Duan, Xuan ; Li, Weihong
  • Subjects: Adult ; Autoantibodies - blood ; Dietary Supplements ; Female ; Glucocorticoids - administration & dosage ; Humans ; Immunoglobulins, Thyroid-Stimulating - immunology ; Infertility, Female - blood ; Infertility, Female - immunology ; Infertility, Female - therapy ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Reproductive Techniques, Assisted ; Retrospective Studies ; Systematic Review and Meta-Analysis ; Thyroiditis, Autoimmune - blood ; Thyroiditis, Autoimmune - immunology ; Thyroiditis, Autoimmune - therapy ; Treatment Outcome
  • Is Part Of: Medicine (Baltimore), 2021-04, Vol.100 (16), p.e25554-e25554
  • Description: Thyroid autoimmune disease (TAI) has been verified to be related to multiple adverse pregnancy outcomes. A growing number of evidences highlight the protective roles of glucocorticoid on the treatments of TAI. This meta-analysis aimed to study whether it is beneficial to add glucocorticoid treatment in infertile women with TAI when they are undergoing assisted reproductive technology (ART). We conducted a systematic search in PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang database, Weipu China Science and Technology Journal Databases (VIP database) up to September 10, 2020. The Revman 5.3 software was utilized for data statistics. We used a random-effects model to analyze data and the odds ratio (OR) combining with 95% confidence interval (95% CI) were employed to reveal the results. Three publications with 237 antithyroid antibody (ATA)-positive and 384 ATA-negative women were included in the final analysis. Overall, glucocorticoid therapy showed satisfying effects on improving clinical pregnancy rate (OR = 4.63, 95% CI [2.23, 9.58], I2 = 0.0%, P < .0001) and live birth rate (OR = 3.19, 95% CI [1.13, 9.04], I2 = 0.0%, P = .03) of ATA-positive women compared with control group. However, it seems that glucocorticoid showed no significant difference in the abortion rate (OR = 0.62, 95% CI [0.09, 4.32], I2 = 35%, P = .64) and oocyte recovery (OR = 2.26, 95% CI [-1.46, 5.99], I2 = 79%, P < .0001) between the 2 groups. Glucocorticoid may improve the pregnancy outcomes of ART women with ATA positive, but there is no significant reduction in the risk of miscarriage. Due to the limited enrolled references, glucocorticoid adjuvant therapy should be applied after more randomized controlled trials.
  • Publisher: United States: Lippincott Williams & Wilkins
  • Language: English
  • Identifier: ISSN: 0025-7974
    EISSN: 1536-5964
    DOI: 10.1097/MD.0000000000025554
    PMID: 33879707
  • Source: IngentaConnect Free/Open Access Journals
    Journals@Ovid Open Access Journal Collection Rolling
    Wolters Kluwer Open Health
    MEDLINE
    PubMed Central
    DOAJ Directory of Open Access Journals
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