Abstract
Objective To evaluate the impact of preconceptional serum TSH levels on the clinical outcomes of infertile patients undergoing their first IUI treatment cycle. Method This was a retrospective study. Euthyroid patients undergoing the first cycle of IUI treatment from Jan 2017 to Aug 2018 were included. The patients were divided into a normal high TSH level (2.5–4.0 mIU/L) group and a low TSH level (0.4–2.5 mIU/L) group. Then, different factors were included separately to compare the outcomes between normal high and low TSH levels. The primary outcomes were clinical pregnancy rates, implantation rates, and miscarriage rates. The secondary outcomes were obstetric outcomes such as single live birth rates, birth length, birth weight, and duration of gestation. Results Initially, 1856 patients were included, and 371 patients were excluded for different reasons. A total of 1485 patients were finally included in the analysis. The general parameters between normal high and low TSH levels were similar except for infertile duration and female BMI, which were, however, significantly different between AID-IUI patients and AIH-IUI patients (P=0.005 and P=0016). No significant differences were found in terms of either primary outcomes or secondary outcomes. Conclusion Normal high-serum TSH levels within the reference range (0.4–4.0 mIU/L) measured before treatment seemed to have no adverse impact on the clinical outcomes of patients undergoing their first IUI treatment cycle.
Highlights
Subclinical hypothyroidism (SCH) was defined as a thyrotropin (TSH) level greater than the upper limit of normal range with normal free thyroxine (FT4) levels [1,2,3]
Despite differences in the methods used in testing TSH and populations included as study objects among the previous studies, the American Society for Reproductive Medicine (ASRM) concluded that insufficient evidence was shown to clarify the association between TSH levels (2.5– 4.0 mIU/L) and miscarriage, and that no solid data were available to evaluate whether TSH levels (2.5–4.0 mIU/L) are associated with adverse obstetric outcomes [4]
The aim of this study was to evaluate the impact of preconceptional TSH levels between 2.5 and 4.0 mIU/L on the clinical outcomes of intrauterine insemination (IUI), which is the first-line treatment provided for infertile couples seeking help from assisted reproduction technology (ART)
Summary
Subclinical hypothyroidism (SCH) was defined as a thyrotropin (TSH) level greater than the upper limit of normal range (which might range from 2.5 to 5.5 mIU/L according to different studies) with normal free thyroxine (FT4) levels [1,2,3]. Despite differences in the methods used in testing TSH and populations included as study objects among the previous studies, the American Society for Reproductive Medicine (ASRM) concluded that insufficient evidence was shown to clarify the association between TSH levels (2.5– 4.0 mIU/L) and miscarriage, and that no solid data were available to evaluate whether TSH levels (2.5–4.0 mIU/L) are associated with adverse obstetric outcomes [4]. The aim of this study was to evaluate the impact of preconceptional TSH levels between 2.5 and 4.0 mIU/L on the clinical outcomes of intrauterine insemination (IUI), which is the first-line treatment provided for infertile couples seeking help from assisted reproduction technology (ART)
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