{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:35:13Z","timestamp":1790832913604,"version":"4.1.0"},"reference-count":85,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Thyroid autoimmunity (TAI) has a high prevalence among women of reproductive age. Investigating its possible impact on ovarian function and fertility is, thus, of utmost relevance. The aim of this systematic review and meta-analysis was to elucidate the effect of TAI on both assisted reproductive technology (ART) outcomes and ovarian reserve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis was restricted to two groups of research articles investigating the association between TAI and: (1) autologous ART outcomes (i.e., fertilization rate [FR], implantation rate, clinical pregnancy rate [CPR], miscarriage rate, and live birth rate), (2) markers of ovarian reserve (i.e., anti-M\u00fcllerian hormone, basal follicle stimulating hormone, antral follicle count, and number of oocytes retrieved). Studies including women affected by overt hypo\/hyperthyroidism were excluded. Relevant studies were identified by a systematic search in PubMed, MEDLINE, ClinicalTrials.gov, Embase, and Scopus, from database inception to May 1, 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      From a total of 432 identified publications, 22 studies were included in Group 1 and 26 studies in Group 2. The presence of TAI was associated with a higher risk of miscarriage (7606 participants, odds ratio [OR] 1.52, confidence interval [CI 1.14\u20132.01],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.004,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200953%), lower chance of embryo implantation (7118 participants, OR 0.72, [CI 0.59\u20130.88],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200936%), and live birth (11417 participants, OR 0.73, [CI 0.56\u20130.94],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200971%). These associations were no longer observed in a subgroup analysis of patients who exclusively underwent intracytoplasmic sperm injection (ICSI). The FR and CPR as well as the mean values of surrogate markers of oocyte quantity appeared not to be affected by TAI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This data synthesis suggest a higher risk of adverse ART outcomes in women with positive TAI. However, the reliability of these findings is hampered by the relatively low quality of the evidence and significant heterogeneity in many of the meta-analyses. The possible protective effect of ICSI is promising but should be confirmed in controlled prospective clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO Registration ID<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">:<\/jats:italic>\n                      CRD42021236529.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2021.0656","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T09:29:52Z","timestamp":1657618192000},"page":"1010-1028","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Impact of Thyroid Autoimmunity on Assisted Reproductive Technology Outcomes and Ovarian Reserve Markers: An Updated Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"32","author":[{"given":"Andrea","family":"Busnelli","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy."},{"name":"Division of Gynecology and Reproductive Medicine, Department of Gynecology, IRCCS Humanitas Research Hospital, Fertility Center, Rozzano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carola","family":"Beltratti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Reproductive Medicine, Department of Gynecology, IRCCS Humanitas Research Hospital, Fertility Center, Rozzano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Bulfoni","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynecology, Humanitas S. Pio X Hospital, Rozzano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lania","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy."},{"name":"Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Emanuele","family":"Levi-Setti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy."},{"name":"Division of Gynecology and Reproductive Medicine, Department of Gynecology, IRCCS Humanitas Research Hospital, Fertility Center, Rozzano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dem408"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","unstructured":"Practice Committee of the American Society for Reproductive Medicine 2020 Testing and interpreting measures of ovarian reserve: A committee opinion. 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