Cargando…

Thyroid function and IVF outcome for different indications of subfertility

GRAPHICAL ABSTRACT: [Image: see text] ABSTRACT: Studies evaluating pregnancy outcomes after assisted reproductive treatment (ART) in women with high-normal (2.5–4.5 mIU/L) thyroid-stimulating hormone (TSH) levels are conflicting, possibly due to different patient charactistics and subfertility indic...

Descripción completa

Detalles Bibliográficos
Autores principales: Repelaer van Driel-Delprat, C C, van Dam, E W C M, van de Ven, P M, Aissa, K, ter Haar, M K, Feenstra, Y, de Roos, A, Beelen, G, Schats, R, Lambalk, C B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8805483/
https://www.ncbi.nlm.nih.gov/pubmed/35118405
http://dx.doi.org/10.1530/RAF-20-0065
_version_ 1784643258092093440
author Repelaer van Driel-Delprat, C C
van Dam, E W C M
van de Ven, P M
Aissa, K
ter Haar, M K
Feenstra, Y
de Roos, A
Beelen, G
Schats, R
Lambalk, C B
author_facet Repelaer van Driel-Delprat, C C
van Dam, E W C M
van de Ven, P M
Aissa, K
ter Haar, M K
Feenstra, Y
de Roos, A
Beelen, G
Schats, R
Lambalk, C B
author_sort Repelaer van Driel-Delprat, C C
collection PubMed
description GRAPHICAL ABSTRACT: [Image: see text] ABSTRACT: Studies evaluating pregnancy outcomes after assisted reproductive treatment (ART) in women with high-normal (2.5–4.5 mIU/L) thyroid-stimulating hormone (TSH) levels are conflicting, possibly due to different patient charactistics and subfertility indications. The aim of this study was to examine the hypothesis that high-normal compared to low-normal TSH levels are associated with adverse implications for pregnancy outcomes in conventional in vitro fertilization (IVF)-treated women. Therefore, we analyzed retrospectively the characteristics and pregnancy outcomes of 949 subfertile women with TSH 0.3–4.5 mIU/L, treated with conventional IVF between January 2008 and March 2012. Demographic and baseline characteristics were compared between groups of patients based on TSH quartiles, using one-way Anova, Kruskal–Wallis ANOVA and chi-square test. Women with high-normal quartile TSH were significantly more likely to be primary subfertile (P = 0.01), with a higher prevalence of unexplained subfertility and with 15% fewer live births after IVF compared to lower TSH quartiles (P = 0.02). In secondary subfertile women with high-normal TSH, male factor subfertility prevailed (P = 0.01), with more live births (P = 0.01). When analyzing primary and secondary subfertile women as one group, these differences failed to be observed, showing no differences in cumulative pregnancy outcomes of IVF between TSH quartiles (I: 0.3–1.21 mIU/L; II: 1.22–1.68 mIU/L; III: 1.69–2.31 mIU/L; IV: 2.32–4.5 mIU/L). In conclusion, primary subfertile women predominate in the high-normal TSH quartile, associated with significantly fewer live births in a subgroup of primary unexplained subfertile women (9%; n  = 87/949), while in secondary subfertile women, dominated by male factor subfertility, high-normal TSH is associated with more live births. LAY SUMMARY: Thyroid hormones are required for all cell processes in the body. An underactive thyroid gland, in which insufficient thyroid hormones are produced and thyroid-stimulating hormone (TSH) rises, is associated with a lower chance of pregnancy. It is not yet clear above which TSH level, 4.5 or also 2.5 mIU/L, this lower probability occurs. Therefore, in 949 couples treated with conventional IVF, we examined whether high-normal TSH levels (TSH: 2.5–4.5 mIU/L) compared to low normal TSH levels (0.3–2.5 mIU/L) affect the live birth rate. We found that women who were trying to become pregnant for the first time, especially without any other cause, that is unexplained subfertility, were more likely to have higher TSH levels. These women had a much lower chance of having a baby compared to women with low-normal TSH levels.
format Online
Article
Text
id pubmed-8805483
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Bioscientifica Ltd
record_format MEDLINE/PubMed
spelling pubmed-88054832022-02-02 Thyroid function and IVF outcome for different indications of subfertility Repelaer van Driel-Delprat, C C van Dam, E W C M van de Ven, P M Aissa, K ter Haar, M K Feenstra, Y de Roos, A Beelen, G Schats, R Lambalk, C B Reprod Fertil Research GRAPHICAL ABSTRACT: [Image: see text] ABSTRACT: Studies evaluating pregnancy outcomes after assisted reproductive treatment (ART) in women with high-normal (2.5–4.5 mIU/L) thyroid-stimulating hormone (TSH) levels are conflicting, possibly due to different patient charactistics and subfertility indications. The aim of this study was to examine the hypothesis that high-normal compared to low-normal TSH levels are associated with adverse implications for pregnancy outcomes in conventional in vitro fertilization (IVF)-treated women. Therefore, we analyzed retrospectively the characteristics and pregnancy outcomes of 949 subfertile women with TSH 0.3–4.5 mIU/L, treated with conventional IVF between January 2008 and March 2012. Demographic and baseline characteristics were compared between groups of patients based on TSH quartiles, using one-way Anova, Kruskal–Wallis ANOVA and chi-square test. Women with high-normal quartile TSH were significantly more likely to be primary subfertile (P = 0.01), with a higher prevalence of unexplained subfertility and with 15% fewer live births after IVF compared to lower TSH quartiles (P = 0.02). In secondary subfertile women with high-normal TSH, male factor subfertility prevailed (P = 0.01), with more live births (P = 0.01). When analyzing primary and secondary subfertile women as one group, these differences failed to be observed, showing no differences in cumulative pregnancy outcomes of IVF between TSH quartiles (I: 0.3–1.21 mIU/L; II: 1.22–1.68 mIU/L; III: 1.69–2.31 mIU/L; IV: 2.32–4.5 mIU/L). In conclusion, primary subfertile women predominate in the high-normal TSH quartile, associated with significantly fewer live births in a subgroup of primary unexplained subfertile women (9%; n  = 87/949), while in secondary subfertile women, dominated by male factor subfertility, high-normal TSH is associated with more live births. LAY SUMMARY: Thyroid hormones are required for all cell processes in the body. An underactive thyroid gland, in which insufficient thyroid hormones are produced and thyroid-stimulating hormone (TSH) rises, is associated with a lower chance of pregnancy. It is not yet clear above which TSH level, 4.5 or also 2.5 mIU/L, this lower probability occurs. Therefore, in 949 couples treated with conventional IVF, we examined whether high-normal TSH levels (TSH: 2.5–4.5 mIU/L) compared to low normal TSH levels (0.3–2.5 mIU/L) affect the live birth rate. We found that women who were trying to become pregnant for the first time, especially without any other cause, that is unexplained subfertility, were more likely to have higher TSH levels. These women had a much lower chance of having a baby compared to women with low-normal TSH levels. Bioscientifica Ltd 2021-10-15 /pmc/articles/PMC8805483/ /pubmed/35118405 http://dx.doi.org/10.1530/RAF-20-0065 Text en © The authors https://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Research
Repelaer van Driel-Delprat, C C
van Dam, E W C M
van de Ven, P M
Aissa, K
ter Haar, M K
Feenstra, Y
de Roos, A
Beelen, G
Schats, R
Lambalk, C B
Thyroid function and IVF outcome for different indications of subfertility
title Thyroid function and IVF outcome for different indications of subfertility
title_full Thyroid function and IVF outcome for different indications of subfertility
title_fullStr Thyroid function and IVF outcome for different indications of subfertility
title_full_unstemmed Thyroid function and IVF outcome for different indications of subfertility
title_short Thyroid function and IVF outcome for different indications of subfertility
title_sort thyroid function and ivf outcome for different indications of subfertility
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8805483/
https://www.ncbi.nlm.nih.gov/pubmed/35118405
http://dx.doi.org/10.1530/RAF-20-0065
work_keys_str_mv AT repelaervandrieldelpratcc thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT vandamewcm thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT vandevenpm thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT aissak thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT terhaarmk thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT feenstray thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT deroosa thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT beeleng thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT schatsr thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility
AT lambalkcb thyroidfunctionandivfoutcomefordifferentindicationsofsubfertility