In contrast, several others found a negative association between antithyroid antibodies and ovarian reserve markers, as did our study (Saglamet al

In contrast, several others found a negative association between antithyroid antibodies and ovarian reserve markers, as did our study (Saglamet al., 2015;Chenet al., 2017;ztrk nsalet al., 2021;Bahriet al., 2019;Samsamiet al., 2020). Reviewing the literature, we found a high heterogeneity between studies regarding the diagnostic criteria for TAI (one or two antibodies) and the markers used to assess ovarian reserve. regression models were Rofecoxib (Vioxx) used. == Results == Overall, there was no difference in the median levels of AMH or AFC between the two groups. However, in the subgroup analysis by age, we observed a trend towards lower median levels of AMH in women over 39 years with TAI (0.9 ng/mL vs. 1.5 ng/mL,p=0.08). In a subanalysis according Rofecoxib (Vioxx) to antibodies, we found a significantly lower median AFC in the group with anti-Tg than in the group without this antibody (8.0 follicles vs. 11.5 follicles,p=0.036). We also found a significantly higher prevalence of anti-Tg in patients Rofecoxib (Vioxx) with low ovarian reserve compared to those with normal reserve (60.7% vs. 39.3%,p=0.038). == Conclusions == The ovarian reserve of women with TAI appears to be insidiously compromised over the years, with a decreased ovarian reserve in women with anti-Tg. Keywords:autoimmune thyroiditis, Hashimotos disease, ovarian reserve, premature ovarian failure, fertility preservation == INTRODUCTION == Autoimmune thyroid diseases represent the most common autoimmune disorders in humans, especially in women of reproductive age (Orgiazzi, 2012;Jacobsonet al., 1997;Goldenet al., 2009). More often, this immune dysfunction selectively affects only the thyroid, but, in many cases, autoimmune thyroid diseases are associated with one or more organ-specific autoimmune dysfunctions. For instance, 12% to 40% of women with premature ovarian failure (POF) are diagnosed with autoimmune thyroid disease (Kirshenbaum & Orvieto, 2019). The occurrence of POF is usually a gradual process characterized by a progressive decline in ovarian reserve. The mechanisms behind this decline are still being elucidated, but the most studied are a reduction in the number of primordial follicles, an accelerated process of follicular atresia and alterations in the recruitment and maturation of primordial follicles (Persaniet al., 2010). The ovarian reserve represents the number of follicles still present in the ovaries. Characteristically, it is influenced by age, genetics, and environmental factors. The antral follicle count (AFC) and the anti-mllerian hormone (AMH) levels reflect the number of follicles still IL1B present in the ovaries and are the most frequently used tests to assess ovarian reserve (Tal & Seifer, 2017). Although it is not yet possible to determine the rhythm of ovarian reserve decline on an individual level, knowledge of its behavior enables counseling on womens reproductive planning. Gonadotoxic oncological treatments, genetic alterations such as mosaic for Turner Syndrome and Fragile X Syndrome, and benign pathologies, such as endometriosis and autoimmune oophoritis, constitute medical indications for fertility preservation, since they represent risk factors for a more accelerated impairment of follicle loss (Ferrarettiet al., 2011). Therefore, in these cases, a more rigorous and specialized follow-up of these women should be indicated. An association between thyroid autoimmune disease and premature ovarian failure has been reported by some authors (Dittmar & Kahaly, 2003;Sleimanet al., 2019;Dolmans & Manavella, 2019). There is evidence that antithyroid antibodies are found in the follicular fluid depending on their serum concentrations (Hoeket al., 1997). Although such intrafollicular antibodies may exert some influence on folliculogenesis, the mechanism of action in oocytes, granulosa cells, or ovarian stromal cells is still unclear (Betterleet al., 1993). In addition, the studies assessing the impact of TAI on the velocity of ovarian reserve decline have presented divergent results, and the current evidence does not enable a definitive conclusion regarding this association (Shahet al., 1995;Weghoferet al., 2016). Therefore, it is of paramount importance to have a better understanding of the behavior of ovarian reserve in women with TAI in order to provide personalized reproductive planning and fertility preservation techniques before POF is established. This study aims to compare the ovarian reserve of women of reproductive age with and without TAI using AMH and AFC values. == MATERIALS AND METHODS == == Study design and population == We retrospectively analyzed the medical records of patients who attended a referral clinic in assisted reproduction located in Recife, Brazil, during the period of February 2017 to December 2021. == Participants == We included women between 18 and 47 years of age with data on the presence of antithyroid antibodies (routinely assessed at first consultation) and assessment of their ovarian reserve through AMH and AFC levels. Women with other possible causes of reduced ovarian reserve such as smoking, previous ovarian surgery, previous gonadotoxic Rofecoxib (Vioxx) treatment, previous pelvic or abdominal radiotherapy, chromosomal abnormalities, history of uterine artery embolization, diagnosis of non-autoimmune hypothyroidism, and Graves disease were excluded. Participants positive for antithyroperoxidase (anti-TPO) and/or antithyroglobulin (anti-Tg) antibodies, according to the reference range of the laboratory where the Rofecoxib (Vioxx) test was performed, were considered to have TAI (Caturegliet al., 2014),.