Impact of Endocrine Disorders on IVF Outcomes: Results from a Large, Single-Centre, Prospective Study

Abstract

Endocrine disorders negatively influence the ovarian function, and increasing incidence of endocrine diseases with age may have further negative effects on pregnancy rate. Prospective cohort study of 231 consecutively enrolled patients underwent IVF treatment. In patients with known endocrine disorders, the laboratory parameters were corrected before IVF treatment. One hundred sixty one patients (69.7%) had at least one known and treated endocrine disorder (study group), and 70 patients were endocrine negative (control group). Endocrine disorders diagnosed were thyroid disorders (32.5%), diminished ovarian reserve (23.8%), insulin resistance (22.5%), PCOS (15.2%), hyperprolactinaemia (13.4%), obesity (12.1%), hypogonadotropic hypogonadism (0.8%) and congenital adrenal hyperplasia (0.2%). Before the IVF treatment, systematic endocrine laboratory examinations were performed in all patients. Higher age, BMI and FSH were found in the study group, while AMH level was lower. There were no differences in LH, E2, prolactin, TSH, FT3, FT4, TT, DHEAS, androstendione, 17-OHP and SHBG level between the study and control groups. The study group had higher baseline glucose, baseline insulin, 120-min glucose and 120-min insulin level after oral glucose tolerance test. With no difference in the IVF cycles performed, pregnancy rate was lower in the study group (61.43% vs. 34.16%; p = 0.003), and this difference (p = 0.0151) remained in age-corrected rates, as well. The analyses were also performed in individual endocrinology groups. The prevalence of endocrine disorders is high in females participating in IVF programs, and they are often accompanying each other. Even after proper correction, the presence of the endocrine disorder negatively influences the pregnancy rate in IVF treatment.

Hashimoto’s Thyroiditis Negatively Influences Intracytoplasmic Sperm Injection Outcome in Euthyroid Women on T4 Substitution Therapy: A Retrospective Study

“…The incidence of both endocrinological disorders (TAI) and anatomical changes (myomas) also increases with advancing age [16]. Further, in a real-world clinical scenario, it is possible to have concurrent endocrine diseases that may influence each other and play a detrimental role on reproductive outcomes in infertile women undergoing IVF/ICSI [3].…”

“…Presumably, high TPOAb titers might alter or destroy endometrial cells, causing chronic endometritis, implantation abnormalities, and recurrent miscarriages [11]. In the light of the above and based on our previously reported findings [3], we hypothesize that TAI-positive women diagnosed with subclinical or overt hypothyroidism, but are euthyroid due to thyroid hormone substitution, may have poorer fertility indicators compared to TAI-negative euthyroid women in an ICSI program.…”

“…Hashimoto's thyroiditis is the most common with a rate of 68% in patients with thyroid abnormalities. Autoimmune thyroiditis is often associated with other endocrinological abnormalities: diminished ovarian reserve (DOR) in 25.45%, PCOS in 20.0%, and hyperprolactinemia in 15.38% [3]. These disorders adversely impact reproductive health, conception as well as pregnancy outcomes [4].…”

Effect of body mass index on pregnancy outcomes: a prospective observational study from a rural south Indian tertiary care setting

“…Recently, the COVID-19 lockdown contributed to a higher proportion of weight gain than in previous years [28]. The BMI can contribute to many other pregnancy complications such as increased risk of stillbirth, altered glucose tolerance, endocrine dysfunctions and its associated gynecological and obstetric outcomes during pregnancy [29,30].…”

Hashimoto’s thyroiditis negatively influences IVF outcome in euthyroid women on T4 substitution therapy; a retrospective study

“…Hashimoto's thyroiditis is the most common with a rate of 68% in patients with thyroid abnormalities. Autoimmune thyroiditis is often associated with other endocrinological abnormalities: Diminished ovarian reserve (DOR) in 25,45%, PCOS in 20.0%, hyperprolactinaemia in 15,38% [3]. Of these, Grave's disease affects 1% of the population, while Hashimoto's thyroiditis prevalence is most common.…”