Donor TSH level is associated with clinical pregnancy among oocyte donation cycles

Karmon, Anatte E.; Cardozo, Eden R.; Souter, Irene; Gold, J.; Styer, Aaron K.

doi:10.1007/s10815-016-0668-6

Cited by 16 publications

(15 citation statements)

References 21 publications

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“…A previous study showed that COS could lead to hyperestrogenism, through a rise in TBG, subsequently leading to a decrease in fT4 [27]. Our results support the theory that the adaptation of maternal THmetabolism to hyperestrogenism during pregnancy may be important for embryo survival [30, 31]. Similarly, COS-specific changesmight put stress on hypothalamus-pituitary-thyroid axis in a very short time and manifest as gestational thyroid disease, which subsequently creates a suboptimal environment during the early phase of implantation, which may increase the risk for IVF failure.…”

Section: Discussionsupporting

confidence: 87%

“…Significant correlations were found between the numbers of retrieved oocytes and fertilized oocytes and serum TSH levels and the FF T4/T3 ratio. Kamron’s study advocates that thyroid function in subfertile women could indicate an insufficient capacity for basic reproductive functions such as oocyte quality, ovulation, fertilization and implantation [30]. Free TH supplementation (50 ng/ml of T3 and T4) led to significant increases in blastocyst formation and hatching rates in bovine embryos [31], and in the expansion rate of the blastocoel cavity of cryopreserved bovine embryos.…”

Section: Discussionmentioning

confidence: 99%

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Serum and follicular fluid thyroid hormone levels and assisted reproductive technology outcomes

Cai

Lin

Zhong

et al. 2019

Reprod Biol Endocrinol

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ObjectiveThe objective ofthis study was to assess the association between thyroid hormone (TH) levels in follicular fluid (FF) and serum and to determine whether THs impact assisted reproductive technology (ART) outcomes.MethodsThis study enrolled 299 women undergoing ART. Blood samples were drawn on the day of human chorionic gonadotrophin (HCG) administrationand analysed for thyroid-stimulating hormone (TSH), thyroxine(T4), triiodothyronine(T3),free T4 (fT4),free T3(fT3), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) levels. FF was obtained on the oocyte pick up (OPU) day and analysed forTSH, T4, T3, fT4, fT3, TPOAb, TgAb and estradiol levels.Results(1) There were significant positive correlations between serum and FF TH and thyroid autoantibody levels. Statistically significant differences were discovered in serum and FF levels of TSH (p ≤ 0.001), T4 (p ≤ 0.001), T3 (p ≤ 0.001), TPOAbs (p ≤ 0.001) and TGAbs (p = 0.021).(2) Serum T4 levels [121.9(104.8,140.8) vs 114.1(98.6,130.6) nmol/l, p = 0.026], serum fT4 levels[(19.0(17.7,21.8) vs 18.6(17.0,20.1) pmol/l, p = 0.026], serum T4/T3 ratios [62.5 (55.7, 66.2) vs 59.4 (53.4, 64.9), p = 0.029], FF fT4 levels [19.0(17.5,21.3) vs 18.1(16.8,19.9) pmol/l, p = 0.009] and FF T4/T3 ratios [52.6 (46.4, 57.3) vs 50.0 (43.7, 53.1), p = 0.004] were significantly higher in the successful pregnancy group than the implantation failure group.(3) Spearman’s rank correlation analysis revealed positive associations of both the FF T4/T3 ratio and serum TSH levels with the numbers of retrieved oocytes (total or MII) and embryos (fertilized, cleavage, and good quality).ConclusionsTH levels in FF are strongly correlated with those in serum on the HCG day, and THs on the HCG day may affect ART outcomes.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Serum and follicular fluid thyroid hormone levels and assisted reproductive technology outcomes

Cai

Lin

Zhong

et al. 2019

Reprod Biol Endocrinol

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“…Details of controlled ovarian hyperstimulation protocols have been described previously (14,15). The individual protocols were chosen by the reproductive endocrinologist on a case by case basis.…”

Section: Methodsmentioning

confidence: 99%

Total number of oocytes and zygotes are predictive of live birth pregnancy in fresh donor oocyte in vitro fertilization cycles

Hariton

Kim

Palmor

et al. 2017

Fertility and Sterility

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Objective To evaluate the association of oocyte donor-recipient characteristics, oocyte donor response, and live birth pregnancy rate (LBR) following fresh donor oocyte IVF-embryo transfer (IVF-ET). Design Retrospective cohort study. Setting Academic reproductive medicine practice Patients Two hundred and thirty-seven consecutive fresh donor oocyte IVF-ET cycles from January 1, 2007 to December 31, 2013 at the Massachusetts General Hospital Fertility Center. Interventions None. Main Outcome Measure Live birth rate per cycle initiated Results The mean (± standard deviation) age of oocyte donors and recipients was 27.0 (± 3.7) and 41.4 (± 4.6) years, respectively. Oocyte donor demographic/reproductive characteristics, ovarian reserve testing, and peak serum estradiol during ovarian stimulation (OS) were similar among cycles which did and did not result in live birth (LB), respectively. Overall implantation, clinical pregnancy, and LBR per cycle initiated were 40.5%, 60.8%, and 54.9%, respectively. The greatest probability of LB was observed in cycles with >10 oocytes retrieved, mature oocytes, oocytes with normal fertilization (zygote-two pronuclear stage), and cleaved embryos, respectively. Conclusion The number of oocytes (total and mature), zygotes, and cleaved embryos are associated with LB following donor oocyte IVF cycles. These findings suggest that specific peri-fertilization factors may be predictive of pregnancy outcomes following donor oocyte IVF cycles.

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“…In women treated with ART, the prevalence of TSH in the range of 2.5–4.5 mIU/L is higher than in the general population: 20–26% compared to 5% (Reh et al , 2010; Michalakis et al , 2011). Some advocate that TSH values >2.5 mIU/L in subfertile women could indicate insufficient capacity for basic reproductive functions such as oocyte quality, ovulation, fertilization and implantation (Karmon et al , 2016).…”

Section: Introductionmentioning

confidence: 99%

Live birth rate after intrauterine insemination is not different between women with lower quartile versus higher quartile normal range thyroid stimulating hormone levels

Driel-Delprat

Dam

Ven³

et al. 2019

Human Reproduction Open

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STUDY QUESTION Does lower quartile normal range thyroid stimulating hormone (TSH) compared to higher quartile normal range in women without thyroid hormone substitution affect live birth rate after a complete IUI treatment series? SUMMARY ANSWER Lower quartile normal range TSH, in women without thyroid hormone substitution, does not affect live birth rate after a complete intrauterine insemination treatment series compared to higher quartile normal range TSH. WHAT IS KNOWN ALREADY TSH is historically seen as the most sensitive test for thyroid function. Its distribution is right-skewed. Whether the preconceptional upper reference TSH values in subfertile women should be 2.5 or 4.5 mIU/L is under debate. Studies have shown that IUI patients treated with levothyroxine for TSH levels above 2.5 mIU/L show higher pregnancy rates. However, no adverse outcome is associated with untreated high normal TSH levels studied in first IUI cycles. Thyroid peroxidase antibodies have also impaired outcomes in some studies whereas others have shown an effect only in combination with high normal TSH levels. As a subgroup, patients with unexplained infertility showed increased levels of TSH. This article adds to the value of TSH evaluation and fertility outcome in four quartiles and in the context of a completed IUI treatment modus of a maximum of six inseminations. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study in 909 women undergoing 3588 IUI cycles starting treatment between the first of January 2008 and the first of March 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS Women aged 22–45 years with TSH 0.3–4.5 mIU/L without thyroid hormone substitution were included at Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands, an Iodine-sufficient area. The primary endpoint was live birth. Clinical pregnancy, pregnancy loss and ongoing pregnancy were secondary endpoints. Logistic regression was used with the natural logarithm of TSH as a continuous predictor. Chi-square tests and logistic regression were used to compare groups of patients based on TSH values in four quartile TSH groups (0.3–1.21 mIU/L; 1.22–1.75 mIU/L; 1.76–2.34 mIU/L; 2.35–4.5 mIU/L) on basic characteristics and on the endpoints while adjusting for confounders. MAIN RESULTS AND THE ROLE OF CHANCE Analysis with the natural logarithm of TSH as a continuous variable showed no association with live birth, pregnancy chance or pregnancy loss. There were no differences in any of the outcomes across the quartile TSH level ranges after regression analysis before and after adjusting for age, BMI, use of alcohol, tobacco, use or gonadotrophins, sperm count, diminished ovarian reserve, unexplained infertility and primary or secondary subfertility. The distribution of primary and secondary subfertility and smoking characteristics were remarkably different across th...

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Donor TSH level is associated with clinical pregnancy among oocyte donation cycles

Cited by 16 publications

References 21 publications

Serum and follicular fluid thyroid hormone levels and assisted reproductive technology outcomes

Serum and follicular fluid thyroid hormone levels and assisted reproductive technology outcomes

Total number of oocytes and zygotes are predictive of live birth pregnancy in fresh donor oocyte in vitro fertilization cycles

Live birth rate after intrauterine insemination is not different between women with lower quartile versus higher quartile normal range thyroid stimulating hormone levels

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