March 23rd, 2018

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Effects of Thyroid-Stimulating Hormone and Thyroid Autoantibodies on Pregnancy Outcome After in Vitro Fertilization and Embryo Transfer
Authors:  Li-Li Zhuang, M.D., Cui-Fang Hao, M.D., Ning Zhang, M.D., Xiao-Yan Liu, M.B., Li Ge, M.B., and Jin-Long Ma, M.D.
  OBJECTIVE: To evaluate the impact of serum thyroid-stimulating hormone (TSH) and thyroid autoantibodies on clinical results for patients after in vitro fertilization and embryo transfer (IVF-ET).

STUDY DESIGN: A retrospective study including 1,129 IVF cycles was performed. All patients were divided into thyroid autoantibodies positive (n=212) and thyroid autoantibodies negative (n=917) groups according to the presence of thyroid autoantibodies. Meanwhile, patients also were divided into 2 subgroups according to the level of TSH; that is, patients with normal TSH (TSH ≤2.5 mIU/L) and patients with higher TSH (TSH >2.5 mIU/L). Our data were from clinical cases, used with patient consent. We analyzed our data to determine whether the outcome for women undergoing IVF is associated with pretreatment serum TSH levels and thyroid autoantibodies.

RESULTS: In women who undergoing first IVF cycle, grade A embryo rates were significantly lower in cycles with a TSH >2.5 mIU/L as compared with TSH ≤2.5 mIU/L. We also found that the presence of thyroid autoantibodies did not influence the clinical pregnancy rate of the first IVF cycles, but the presence of thyroid autoantibodies in patients with TSH >2.5 mIU/L caused a higher miscarriage rate which was not found in patients with TSH ≤2.5 mIU/L.

CONCLUSION: We recommend screening for thyroid disorders and treatment with levothyroxine if serum TSH is >2.5 mIU/L before IVF, especially in patients with thyroid autoimmunity.
Keywords:  assisted reproductive techniques, autoantibodies, embryo transfer, hypothyroidism, in vitro fertilization, TSH, thyroid autoantibodies, thyroid-stimulating hormone, thyrotropin
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