Document Detail


In vitro fertilization pregnancy rates in levothyroxine-treated women with hypothyroidism compared to women without thyroid dysfunction disorders.
MedLine Citation:
PMID:  22540326     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Untreated hypothyroidism can lead to ovulatory dysfunction resulting in oligo-amenorrhea. Treatment with levothyroxine can reverse such dysfunction and thus should improve fertility. The purpose of this retrospective study was to assess whether in vitro fertilization (IVF) pregnancy rates differ in levothyroxine-treated women with hypothyroidism compared to women without thyroid dysfunction/disorders.
METHODS: Treated hypothyroid and euthyroid women undergoing IVF at an academic IVF center were studied after Institutional Review Board approval. Women with hypothyroidism were treated with levothyroxine 0.025-0.15 mg/day for at least 3 months to maintain baseline thyrotropin (TSH) levels of 0.35-4.0 μU/mL prior to commencing IVF treatment (HYPO-Rx group). Causes of infertility were similar in both groups with the exception of male factor, which was more common in the HYPO-Rx group. The main outcomes studied were implantation rate, clinical pregnancy rate, clinical miscarriage rate, and live birth rate.
RESULTS: We reviewed the first IVF retrieval cycle performed on 240 women aged 37 years or less during the period January 2003 to December 2007. Women with treated hypothyroidism (n=21) had significantly less implantation, clinical pregnancy, and live birth rates than euthyroid women (n=219).
CONCLUSIONS: We conclude that, despite levothyroxine treatment, women with hypothyroidism have a significantly decreased chance of achieving a pregnancy following IVF compared to euthyroid patients. A larger prospective study is necessary to assess confounding variables, confirm these findings, and determine the optimal level of TSH prior to and during controlled ovarian hyperstimulation for IVF.
Authors:
Bert Scoccia; Habibe Demir; Yuna Kang; Michelle A Fierro; Nicola J Winston
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-04-27
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  22     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-06     Completed Date:  2012-10-30     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  631-6     Citation Subset:  IM    
Affiliation:
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois College of Medicine, 820 South Wood St., Chicago, IL 60612-7313, USA. bscocc@uic.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Amenorrhea / etiology
Cohort Studies
Female
Fertilization in Vitro*
Humans
Hypothyroidism / blood,  complications,  drug therapy*
Infertility, Female / etiology
Pregnancy
Pregnancy Complications / blood,  drug therapy
Pregnancy Rate*
Retrospective Studies
Thyrotropin / blood
Thyroxine / therapeutic use*
Grant Support
ID/Acronym/Agency:
UL1 RR029879/RR/NCRR NIH HHS; UL1RR029879/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
7488-70-2/Thyroxine; 9002-71-5/Thyrotropin
Comments/Corrections
Comment In:
Thyroid. 2012 Dec;22(12):1298-9; author reply 1298-300   [PMID:  22966932 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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