Abstract
BackgroundPrevious studies examining associations between subclinical hypothyroidism (SCH) with in vitro fertilization (IVF) outcome indicate some benefits of levothyroxine (LT4) treatment. But IVF outcomes in treated SCH women whose serum Thyroid Stimulating Hormone (TSH) concentration did and did not exceed 2.5 mIU/L before the IVF cycle has not been studied thoroughly.MethodsIn this study, we performed a prospective cohort study with 270 treated subclinical hypothyroidism patients undergoing their first IVF retrieval cycle at a single cite.ResultsSCH in women receiving LT4 replacement with a basal TSH level between 0.2-2.5mIU/L displayed a similar rate of clinical pregnancy (47.4% vs 38.7%, P = .436), miscarriage (7.4% vs 16.7%, P = .379) and live birth (43.9% vs 32.3%, P = .288) compared to women with a basal TSH level between 2.5-4.2 mIU/L.ConclusionStrictly controlled TSH (less than 2.5 mIU/L) before IVF may have no effect on the pregnancy rate in LT4 treated SCH women.
Highlights
Previous studies examining associations between subclinical hypothyroidism (SCH) with in vitro fertilization (IVF) outcome indicate some benefits of levothyroxine (LT4) treatment
Our aim was to investigate the rate of pregnancies of IVF in SCH women substituted with L-T4 and evaluate whether Thyroid Stimulating Hormone (TSH) less than 2.5 mIU/l is the optimal cut-off point before IVF cycle
We found in a cohort of 4720 subfertile women undergoing IVF that 5.8% of them had SCH
Summary
Previous studies examining associations between subclinical hypothyroidism (SCH) with in vitro fertilization (IVF) outcome indicate some benefits of levothyroxine (LT4) treatment. IVF outcomes in treated SCH women whose serum Thyroid Stimulating Hormone (TSH) concentration did and did not exceed 2.5 mIU/L before the IVF cycle has not been studied thoroughly. Several investigations showed that IVF had an effect on serum TSH level in L-T4 treated hypothyroid women [8]. The majority of evidence shows that SCH has a negative effect on outcome of IVF [9] Whether this negative influence may be attenuated with LT4 treatment, the benefits of strictly controlled TSH level before IVF are still unknown [3, 9].
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