Abstract
PurposeWe investigated the effect of different surgical procedures and radioactive iodine treatment (RAIT) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes and evaluated whether possible risk factors, including age, thyroid-stimulating hormone (TSH) levels, and thyroid antibody positivity, were associated with adverse IVF/ICSI outcomes.MethodsThis retrospective study included 76 women with infertility who had received thyroid cancer (TC) treatment among 137,698 infertile women who underwent IVF/ICSI cycles at the Peking University Third Hospital between 2010 and 2019. Clinical pregnancy and live birth rates were assessed.ResultsWe found that the clinical pregnancy and live birth rates in women who underwent partial thyroidectomy were 7- and 6-fold higher, respectively, than those in women who underwent total thyroidectomy. We observed no significant differences in the clinical pregnancy and live birth rates between the RAIT and non-RAIT groups, even after adjusting for age, TSH levels, surgical treatment, and thyroid antibody positivity. Multivariate logistic regression analysis showed that age and TSH levels were not associated with decreased clinical pregnancy and live birth rates. Women with thyroid antibody positivity had significantly lower clinical pregnancy and live birth rates than women without thyroid antibody positivity.ConclusionOur study showed lower clinical pregnancy and live birth rates in women who underwent total thyroidectomy than in women who underwent partial thyroidectomy. Thyroid antibody positivity is an important risk factor for adverse IVF/ICSI outcomes in women who have received TC treatment.
Highlights
Several studies have demonstrated a significant association between reproductive factors and the risk of thyroid cancer (TC), and a higher prevalence of TC has been observed in women with infertility than in those without infertility [1,2,3]
This study aimed to investigate the effect of different types of surgical procedures and radioactive iodine treatment (RAIT) on IVF/ICSI outcomes in women with TC and analyze whether possible risk factors, including age, thyroid-stimulating hormone (TSH) levels, and thyroid antibody positivity, were associated with adverse IVF/ICSI outcomes
TSH levels were significantly lower in women who underwent total thyroidectomy than in women who underwent partial thyroidectomy
Summary
Several studies have demonstrated a significant association between reproductive factors and the risk of thyroid cancer (TC), and a higher prevalence of TC has been observed in women with infertility than in those without infertility [1,2,3]. For women with TC complicated by infertility, a careful balance between TC and assisted reproductive treatment is Sufficient thyroid hormone secretion and a normal thyroid gland regulatory capacity are essential for follicular growth, pregnancy maintenance, and fetal development [4]. Both hyperthyroidism and hypothyroidism during pregnancy may be associated with adverse pregnancy outcomes [5]. Partial or total thyroidectomy combined with thyroid hormone suppression remains the standard treatment for patients with TC. Whether different surgical procedures trigger different pregnancy outcomes in women with TC remains unknown
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