PRESENCE OF THYROID ANTIBODIES IN EARLY REPRODUCTIVE FAILURE - BIOCHEMICAL VERSUS CLINICAL PREGNANCIES

Objective: To evaluate the clinical usefulness of thyroid antibodies i n determining early pregnancy outcome. Setting: University-based facil ity at the Center for Reproductive Health, University of California, I rvine. Patients: Four hundred eighty-seven infertile patients that suc cessfully conceived with assisted reproductive techniques from January 1991 to December 1992.Interventions: An enzyme immunoassay for semiqu antification of thyroglobulin (TG) and thyroid peroxidase antibodies u sed to determine antibody status from stored serum of these patients. Main Outcome Measure: Thyroid antibody status in early pregnancy. Resu lts: Of the 487 patients studied, there were 106 women who were antibo dy positive for anti-TG, antithyroid peroxidase, or both, and 381 who were negative. The overall incidence of positivity was 22%. In the ant ibody-positive group there was a 32% clinical miscarriage rate in comp arison to 16% in the antibody-negative group. This did reach statistic al significance. There was no significant difference between the two g roups in the incidence of biochemical or ectopic pregnancies. There al so was no significant difference between the groups in age, gravidity, or number of prior pregnancy losses. Conclusion: In our patient popul ation, thyroid antibodies proved to be a useful marker for identifying women at risk for clinical miscarriage but they appear not to have an association with biochemical pregnancies.