Impact of thyroid cancer treatment on assisted reproductive technology outcomes in women with infertility

Abstract

Purpose We investigated the effect of different surgical procedures and radioactive iodine treatment (RAIT) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes and evaluated whether possible risk factors, including age, thyroid-stimulating hormone (TSH) levels, and thyroid antibody positivity, were associated with adverse IVF/ICSI outcomes. Methods This retrospective study included 76 women with infertility who had received thyroid cancer (TC) treatment among 137,698 infertile women who underwent IVF/ICSI cycles at the Peking University Third Hospital between 2010 and 2019. Clinical pregnancy and live birth rates were assessed. Results We found that the clinical pregnancy and live birth rates in women who underwent partial thyroidectomy were 7- and 6-fold higher, respectively, than those in women who underwent total thyroidectomy. We observed no significant differences in the clinical pregnancy and live birth rates between the RAIT and non-RAIT groups, even after adjusting for age, TSH levels, surgical treatment, and thyroid antibody positivity. Multivariate logistic regression analysis showed that age and TSH levels were not associated with decreased clinical pregnancy and live birth rates. Women with thyroid antibody positivity had significantly lower clinical pregnancy and live birth rates than women without thyroid antibody positivity. Conclusion Our study showed lower clinical pregnancy and live birth rates in women who underwent total thyroidectomy than in women who underwent partial thyroidectomy. Thyroid antibody positivity is an important risk factor for adverse IVF/ICSI outcomes in women who have received TC treatment.

Thyroid cancer in women of reproductive age: Key issues for the clinical team

“… 17 In advanced thyroid cancer stages or worse prognosis, the ART become a suitable option to discuss with due to the need to postpone pregnancy and minimizing age factor on ovarian reserve. 32 , 35 …”

“…17 In advanced thyroid cancer stages or worse prognosis, the ART become a suitable option to discuss with due to the need to postpone pregnancy and minimizing age factor on ovarian reserve. 32,35 Warranting women reproductive and sexual rights 27,37 is among our task after thyroid cancer is diagnosed since there is a clear and direct relation among thyroid hormones, pregnancy, and fetal physiology. We need to raise the awareness and offer the various preserving fertility options as well as transmitting the importance of a normal thyroid function and antibodies profile in order to obtain and maintain pregnancy.…”

“… 32 In advanced thyroid cancer patients or even women with thyroid cancer in situ complicated by infertility who had pregnancy desires, ART becomes a feasible option. 35 Table 1 summarizes the different fertility preservation techniques available to date, their considerations, and limitations as an accessible tool for the approach of all specialists. 7 , 36 , 37 …”

Progress and challenges of mRNA vaccines

“…Clinical data showed that COVID‐19 mRNA vaccines offer protection rates of up to 95% (Pfizer/BioNTech & Moderna) 7,8 and also have high production capacity and a rapid development cycle. Overall, mRNA vaccine technology has significant benefits in terms of controlling outbreaks of infectious diseases 9–11 …”

What is the impact of thyroid cancer history on in vitro fertilization: A cohort study

“…Thyroidectomy and long-term thyroid hormone-suppression therapy could lower the chance of tumor recurrence, but the resulting partial or total reduction in thyroid function may impact female fertility and result in adverse pregnancy outcomes [9]. I-131 therapy is commonly used for remnant ablation and adjuvant therapy [10].…”