Does subclinical hypothyroidism and/or thyroid autoimmunity influence the IVF/ICSI outcome? Review of the literature

Safarian, Galina Khachikovna; Gzgzyan, Alexander M.; Lyailya, Kharryasovna Dzhemlikhanova; Niauri, Dariko A.

doi:10.1080/09513590.2019.1653564

Cited by 23 publications

(14 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, there were studies failed to show any significant difference between the anti-TPO+ and anti-TPO− group with respect to live birth delivery, pregnancy or miscarriage, and the same results were presented when comparing subgroups according to TSH level (15). LT4 supplementation should be recommended to improve clinical pregnancy outcomes in women with thyroid dysfunction, and in infertile women with SCH and/or TAI who are undergoing IVF, mostly to reduce the miscarriage rate (16). Mature (MII) oocytes from women undergoing IVF contain thyroid hormone (TR) 1, TR 2, TR 1 and TR 2 mRNA, suggesting a possible direct effect of triiodothyronine (T3) on the human oocyte (17).…”

Section: Discussionmentioning

confidence: 91%

Pregnancy outcomes and newborn characteristics in women with follicular fluid thyroid autoantibodies undergoing assisted reproduction

Medenica¹,

Garalejić²,

Abazović³

et al. 2023

J Med Biochemistry

View full text Add to dashboard Cite

Background: Higher levels of thyroid autoantibodies in follicular fluid (FF) of thyroid autoimmunity (TAI) positive women are strongly correlated with serum levels and may have effect on the post-implantation embryo development. Literature highlights that levothyroxine (LT4) treatment may attenuate the risk of adverse pregnancy outcomes. The aim of the study was to estimate the pregnancy and newborn outcomes in women with FF thyroid autoantibodies undergoing assisted reproductive technology (ART). Methods: The study population included 24 women with confirmed clinical pregnancy, 8 TAI positive and 16 TAI negative women. LT4 supplementation was applied in 20.8% patients, TAI positive. Results: Pregnancy outcomes were: twin pregnancy rate 41.7%, early miscarriage rate 8.3%, late miscarriage rate 4.2%, preterm birth rate 16,7%, term birth rate 70.8%, live birth rate 96.0%. There was significant difference in serum and in FF TgAbs (p<0.001) between the groups according to TAI, while serum fT3 was lower in the group with TAI (p=0.047). Serum fT4 was higher in LT4 treated group (p=0.005), with TAI, and newborns in this group had higher birth weight (p=0.001) and height (p=0.008). Maternal complications occurred in 23.8% of patients. No congenital malformations in newborns were noted. Conclusions: Thyroid autoantibodies present in FF may have an effect on the post-implantation embryo development, but have no effect on further course of pregnancy. The special benefit of LT4 treatment for successful ART outcome was demonstrated for newborn anthropometric parameters.

show abstract

Section: Discussionmentioning

confidence: 91%

Pregnancy outcomes and newborn characteristics in women with follicular fluid thyroid autoantibodies undergoing assisted reproduction

Medenica¹,

Garalejić²,

Abazović³

et al. 2023

J Med Biochemistry

View full text Add to dashboard Cite

show abstract

“…In contrast, Yamamoto JM et al [24] in a systematic review and meta-analysis of randomized controlled trials found no benefit of therapy on obstetric, neonatal, childhood intelligent quotient (IQ) or neurodevelopmental outcomes and they concluded that currently, there was no evidence to support the treatment of subclinical hypothyroidism diagnosed in pregnancy. Moreover, the role of subclinical hypothyroidism and thyroid autoimmunity on assisted reproductive technology (ART) success rate was recently found to be controversial [25]. Our patients did not receive treatment with Levo-thyroxine.…”

Section: Discussionmentioning

confidence: 93%

Thyroid stimulating hormone (TSH) level variations in early pregnancy and feto-maternal outcome; retrospective study

2020

Clinical and Experimental Obstetrics & Gynecology

View full text Add to dashboard Cite

Introduction: Thyroid disease is the second most common endocrine disorder affecting women of reproductive age. The debate continues which TSH levels need to be considered as a reflection of subclinical hypothyroidism in pregnancy. Our aim was to find out if variations in the level of thyroid stimulating hormone (TSH) in early pregnancy of women not known to have thyroid disease or anti-thyroid antibodies were linked to different fetomaternal outcomes. Materials and Methods: Retrospective comparative study that compared group 1 (TSH level 0.1-1.99 mIU/L) and group 2 (TSH level 2.0-4 mIU/L). Each group was further subdivided into primigravidae and multipara with a total of 1527 pregnant women included in the study. Results: The body mass index (BMI), was statistically higher in primiparous women in group 2 (P2) than primiparous in group 1 (P1), (mean BMI 28.0 vs. 26.9, respectively, P value 0.014). The odds ratio of miscarriage in the primigravidae in group 2 was 1.24. This was not statistically significant (95% confidence interval; 0.42-3.63). The miscarriage rate was not also statistically different between multipara (odds ratio 1.04, 95% CI 0.6-1.7). For the primigravid groups, the odds of developing gestational diabetes mellitus was significantly higher in group 2 than in group 1 (Odds Ratio = 2.6, 95% CI 1.2-5.4). This was not seen in multiparous women. This difference could be explained by the higher BMI in group 2. There was a significant difference in the mean arterial blood pressure in multipara between the 2 groups. Although the values of the mean blood pressure (85 and 84 mmHg) were close, the P-value of the t-test performed was 0.007 possibly due to the difference in variance and sample size of each group. There were no statistical difference in the mean gestational age at delivery, preterm birth, mode of delivery and birth weight of term and preterm deliveries. Conclusions: In singleton pregnancies of women without thyroid dysfunction and with negative anti-thyroid antibodies, variations of the TSH level in early pregnancy up to 4.0 mIU/L were not associated with a significant difference in most of the fetomaternal outcomes. TSH values between 2.0-4.0 mIU/L were found to be associated with gestational diabetes in primigravid women and higher mean arterial blood pressure in multiparous women.

show abstract

“…We performed ICSI procedure for all patients but we observed only a tendency on embryo quality in favor of ATA-negative cases (p = 0.09). Safarian et al have also concluded that ICSI procedure is a preferred method in women with positive ATA [30].…”

Section: Discussionmentioning

confidence: 97%

The impact of thyroid autoantibodies on the cycle outcome and embryo quality in women undergoing intracytoplasmic sperm injection

Tokgöz

Isim

Tekin

2020

Middle East Fertil Soc J

View full text Add to dashboard Cite

Background: The influence of thyroid autoimmunity in in-vitro fertilization/intracytoplasmic sperm injection (ICSI) cycles is still a controversial issue. Although some women are euthyroid, some studies found thyroid dysfunction and thyroid autoimmunity increased the incidence of infertility. We aimed to evaluate the impact of anti-thyroid antibodies on the cycle parameters, embryo quality, and pregnancy outcomes in women who underwent ICSI cycles. Results: Fertilization rate was significantly higher in anti-thyroid antibody-negative patients than in anti-thyroid antibody-positive patients (97.1 ± 10.5 vs. 91.5 ± 19.8, respectively, p = 0.003). Clinical pregnancy, miscarriage, and ongoing pregnancy rates were not different among study groups. The presence of top-quality embryo was lower in anti-thyroid antibody-positive patients but it did not reach any statistical significance (56.5% vs. 67.8%, p = 0.09). In the subgroup analysis, there were no significant differences except for the miscarriage rate according to the TSH threshold. Conclusion: The clinical pregnancy and ongoing pregnancy were not affected by the positivity of anti-thyroid antibodies. We showed that thyroid autoimmunity may have an impact on fertilization rate and embryo quality in patients undergoing ICSI cycles. Miscarriage rate also increases with thyroid autoimmunity and TSH levels above 2.5 μIU/L.

show abstract

Does subclinical hypothyroidism and/or thyroid autoimmunity influence the IVF/ICSI outcome? Review of the literature

Cited by 23 publications

References 30 publications

Pregnancy outcomes and newborn characteristics in women with follicular fluid thyroid autoantibodies undergoing assisted reproduction

Pregnancy outcomes and newborn characteristics in women with follicular fluid thyroid autoantibodies undergoing assisted reproduction

Thyroid stimulating hormone (TSH) level variations in early pregnancy and feto-maternal outcome; retrospective study

The impact of thyroid autoantibodies on the cycle outcome and embryo quality in women undergoing intracytoplasmic sperm injection

Contact Info

Product

Resources

About