【摘要】 目的 分析行体外受精-胚胎移植患者甲状腺自身抗体与抗米勒管激素(AMH)的关系，探讨二者对助孕结局的影响。方法 2019年1月—2022年4月河南省人民医院行体外受精-胚胎移植助孕的甲状腺功能正常患者899例，检测入院时甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)及促甲状腺激素受体抗体(TRAb)水平。以TPOAb、TgAb、TRAb任意1项阳性(TPOAb>34 u/mL、TgAb>115 u/mL、TRAb>1.75 u/mL)为甲状腺自身抗体阳性，将899例患者分为自身抗体阳性组412例和自身抗体阴性组487例。比较2组年龄，体质量指数，不孕时间，血清卵泡刺激素、黄体生成素、雌二醇、AMH水平及临床妊娠率和活产率；Pearson相关法分析AMH与TPOAb、TgAb、TRAb的相关性。结果 自身抗体阳性组AMH水平[(2.31±0.89)μg/L]低于自身抗体阴性组[(3.22±1.07)μg/L](t=2.361,P=0.009),年龄，体质量指数，不孕时间及血清卵泡刺激素、黄体生成素、雌二醇水平与自身抗体阴性组比较差异均无统计学意义(P>0.05)。自身抗体阳性组活产率(39.6%)低于自身抗体阴性组(58.7%)(χ~2=5.763,P=0.008),临床妊娠率(58.5%)与自身抗体阴性组(61.8%)比较差异无统计学意义(χ~2=1.571,P=0.213)。899例患者血清TPOAb、TgAb、TRAb水平分别为(30.92±19.75)(78.36±59.86)(1.51±0.94)u/mL,血清AMH与TPOAb(r=-0.228,P=0.017)、TgAb(r=-0.209,P=0.035)、TRAb(r=-0.187,P=0.046)均呈负相关。结论 甲状腺自身抗体阳性者卵巢储备功能下降，行体外受精-胚胎移植活产率降低，血清TPOAb、TgAb、TRAb水平增高者，AMH水平降低。更多还原

【Abstract】 Objective To observe the relationship between thyroid autoantibodies and anti-Müllerian hormone(AMH) in patients undergoing in vitro fertilization-embryo transfer(IVF-ET)),and to investigate their influences on the outcome of IVF-ET.Methods A total of 899 patients with normal thyroid function underwent IVF-ET in Henan Provincial People’s Hospital from January 2019 to April 2022.The serum levels of thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb) and thyrotropin receptor antibody(TRAb) were detected on admission.TPOAb,TgAb or TRAb positive(TPOAb>34 u/mL,TgAb>115 u/mL,or TRAb>1.75 u/mL) indicated positive thyroid autoantibodies,and 899 patients were divided into autoantibodies-positive group(n=412) and autoantibodies-negative group(n=487).The age,body mass index,infertility years,levels of follicle stimulating hormone,luteinizing hormone,estradiol and AMH,clinical pregnancy rate and live birth rate were compared between two groups.Pearson correlation method was used to analyze the correlations of serum AMH with TPOAb,TgAb and TRAb levels.Results The AMH level was lower in autoantibodies-positive group [(2.31 ± 0.89) μg/L] than that in autoantibodies-negative group[(3.22±1.07)μg/L](t=2.361,P=0.009),and there were no significant differences in the age,body mass index,infertility duration,follicle stimulating hormone,luteinizing hormone and estradiol between two groups(P>0.05).The live birth rate was lower in autoantibodies-positive group(39.6%) than that in autoantibodies-negative group(58.7%)(χ~2=5.763,P=0.008),and there was no significant difference in clinical pregnancy rate between autoantibodies-positive group(58.5%) and autoantibodies-negative group(61.8%)(χ~2=1.571,P=0.213).The serum TPOAb,TgAb and TRAb of 899 patients were(30.92±19.75),(78.36±59.86) and(1.51±0.94) u/mL,respectively.The serum AMH level was negatively correlated with TPOAb(r=-0.228,P=0.017),TgAb(r=-0.209,P=0.035) and TRAb(r=-0.187,P=0.046).Conclusions The patients with positive thyroid autoantibodies have a deminished ovarian reserve.The live birth rate is low after IVF-ET.Serum TPOAb,TgAb and TRAb are negatively correlated with AMH level.更多还原