Improved in Vitro Fertilization Outcomes after Treatment of Subclinical Hypothyroidism in Infertile Women

Rahman, Ashraf Farrag; Abbassy, Hadeer A; Abbassy, A. A.

doi:10.4158/ep09365.or

Cited by 83 publications

(84 citation statements)

References 23 publications

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“…Indeed, average TSH levels in infertile women were reportedly higher than those in normal fertile women [4,5]. And elevated serum TSH levels were associatAlthough levothyroxine replacement therapy for subclinical hypothyroidism in infertile patients remains debatable, thyroxine supplementation may improve fertility, in particular, implantation and miscarriage rates, leading to successful pregnancy [7,8]. These data suggest that hypothyroidism is strongly correlated with infertility.…”

Section: Introductionmentioning

confidence: 99%

Elevated serum thyroid-stimulating hormone is associated with decreased anti-Müllerian hormone in infertile women of reproductive age

Kuroda

Uchida

Saki

et al. 2014

J Assist Reprod Genet

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Purpose Thyroid dysfunction and autoimmune thyroiditis are associated with fertility in women of reproductive age. AntiMüllerian hormone (AMH), a known biomarker of ovarian function, may be affected by impaired thyroid function; however, the relationship between AMH and thyroid hormone has not been elucidated. Methods In this case-control study, to identify the impact of thyroid hormone on ovarian reserve, we recruited 67 consecutive Japanese infertile patients and 27 normal fertile women aged 30-39 years without impact factors on thyroid and ovarian functions between 2012 and 2013. We assessed patient age, BMI and AMH, prolactin, TSH and FT4 levels of all study participations as independent variables. To evaluate the relationship between AMH and thyroid hormone, we matched patients by age and body mass index as confounding factors using 1:1 matching for statistical analysis of healthy fertile women and infertile patients and obtained 23 pairs. Then, independent variables were subjected to multiple regression analysis.Results Multiple regression analysis showed that both thyroid-stimulating hormone (TSH) levels and patient age were negatively correlated with AMH levels in infertile patients (patient age and TSH: standardized partial regression coefficient (β), −0.534 and −0.361; p=0.003 and 0.036, respectively), but not in normal fertile women. Conclusions AMH levels were inversely correlated with TSH levels in infertile women of reproductive age.

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Section: Introductionmentioning

confidence: 99%

Elevated serum thyroid-stimulating hormone is associated with decreased anti-Müllerian hormone in infertile women of reproductive age

Kuroda

Uchida

Saki

et al. 2014

J Assist Reprod Genet

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“…However, Maruo et al reported that thyroid hormones synergize with FSH to exert direct stimulatory effects on granulosa cell functions, including morphological differentiation, luteinizing hormone/human chorionic gonadotropin (hCG) receptor formation, and steroidogenic enzyme induction, and decreases in ovarian functions during hypothyroidism may account for diminished responsiveness of the granulosa cells to FSH [1]. In addition, Abdel Rahman et al reported that LT4 treatment should be recommended to achieve clinical pregnancies in women with SCH who are undergoing in vitro fertilizationintracytoplasmic sperm injection [8]. LT4 is one of the safest drugs in that it seldom shows adverse effects, and is particularly cost-effective.…”

Section: Discussionmentioning

confidence: 99%

“…In these studies, adequate supplementation of LT4 improved embryo quality and pregnancy outcome [4,8]. In Japan, a country with excessive iodine intake, treatment for SCH in infertile women has generally been performed.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Clinical Features of Infertile Women With Subclinical Hypothyroidism in Relatively High-Iodine-Intake Area

et al. 2015

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Background: It is well known that hypothyroidism may cause menstrual abnormalities, infertility, increased risk of miscarriage, obstetric complications, and adverse outcomes in offspring. On the other hand, some studies have reported the efficacy of supplementation of levothyroxine (LT4) for subclinical hypothyroidism (SCH) in infertile women. The aim of this study was to evaluate the clinical features of infertile SCH patients in Japan.

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“…When the interventional studies with levothyroxine performed so far are reviewed (Table 3) (61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76), they seem to be more effective in preventing adverse obstetric events (mainly miscarriage and preterm delivery) in cases where AITD was present. All these studies have provided us with a more precise understanding of how to identify women at risk of developing pregnancy complications and will probably lead to better indications for therapy and consequently, more effective treatments.…”

Section: In Favour Of Treating Subclinical Thyroid Dysfunctionmentioning

confidence: 99%

Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies

Velasco

Taylor

2018

European Journal of Endocrinology

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Thyroid hormones are essential for an adequate growth and development of the fetus. In addition to the classical association between maternal hypothyroidism and neurological impairment in the progeny, other adverse reproductive events have been associated with maternal thyroid dysfunction including infertility, miscarriage and preterm delivery. Although all scientific societies endorse the treatment of overt hypothyroidism; the management and/or treatment of subclinical hypothyroidism, hypothyroxinemia or antithyroid antibody-positive women should be considered with caution. Important trials have found no clear benefit of treatment of subclinical hypothyroidism in terms of cognitive outcomes; however, other interventional studies appear to reduce some of the obstetric and perinatal complications. As a result, the dilemma between universal screening or selective screening of women at high risk of thyroid dysfunction during pregnancy remains unresolved. Despite this, levothyroxine is also now regularly prescribed by gynaecologists and centres for reproductive medicine. In this context, there is increasing concern regarding the risk of over diagnosis and subsequent potential overtreatment. Taken together, we need to reconsider how thyroid dysfunction should be identified in pregnant women and highlight the arguments for and against the use of levothyroxine in obstetric practices. Our main findings: the mismatch between the guidelines recommendations and the use of LT4 in clinical settings as well as the disparity of criteria between scientific societies from different medical specialties. In conclusion, it is essential to reach agreements between both endocrinologists and obstetricians.

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Improved in Vitro Fertilization Outcomes after Treatment of Subclinical Hypothyroidism in Infertile Women

Cited by 83 publications

References 23 publications

Elevated serum thyroid-stimulating hormone is associated with decreased anti-Müllerian hormone in infertile women of reproductive age

Elevated serum thyroid-stimulating hormone is associated with decreased anti-Müllerian hormone in infertile women of reproductive age

Evaluation of the Clinical Features of Infertile Women With Subclinical Hypothyroidism in Relatively High-Iodine-Intake Area

Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies

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