Preconceptional thyroid-stimulating hormone levels and outcomes of intrauterine insemination among euthyroid infertile women

Karmon, Anatte E.; Batsis, Maria; Chavarro, Jorge E.; Souter, Irene

doi:10.1016/j.fertnstert.2014.09.035

Cited by 47 publications

(44 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given the small number of SABs, it is not possible to draw any conclusions regarding a possible association with donor TSH. A previous study evaluating TSH levels in ovulation induction cycles did demonstrate a higher rate of SABs among women with pre-treatment TSH levels <2.5mIU/L [14].…”

Section: Discussionmentioning

confidence: 80%

“…This level was chosen due to evidence that pregnancy reference intervals for TSH are lower than those of the general population [20], and recent guidelines suggest that pre-conceptional TSH should be corrected to <2.5 mIU/L, even in euthyroid women [11]. This statement is not without controversy, as some studies have not observed a relationship between pre-conceptional TSH level and fertility treatment outcome among euthyroid women [14,21,22]. Nevertheless, our current results suggest that pre-fertilization donor TSH level may play a role in treatment outcome, specifically among women undergoing IVF with donor oocytes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Karmon

Cardozo

Souter

et al. 2016

J Assist Reprod Genet

Self Cite

View full text Add to dashboard Cite

Purpose The purpose of the study is to evaluate the association between donor TSH level (independent of recipient TSH level) and recipient pregnancy outcome among fresh donor oocyte IVF cycles. Methods This is a retrospective cohort study investigating 232 consecutive fresh donor-recipient cycles (200 total oocyte donors) at an academic medical center. Main outcome measures include clinical pregnancy and live birth. Results Cycles were categorized into two groups based on donor TSH level (< 2.5 and ≥ 2.5 mIU/L). After controlling for multiple donor and recipient characteristics, the probability of clinical pregnancy was significantly lower among donors with TSH levels ≥2.5 mIU/L compared to those with TSH values <2.5 mIU/L (43.1 %, 95 % CI 28.5-58.9, versus 66.7 %, 95 % CI 58.6-73.9, respectively, p = 0.01). The difference in live birth rates between the two groups did not achieve statistical significance (43.1 %, versus 58.0 %,, respectively, p = 0.09). Conclusions Donor TSH level, independent of recipient TSH level, is associated with recipient clinical pregnancy. These findings suggest that thyroid function may impact the likelihood of pregnancy at the level of the oocyte.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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

Karmon

Cardozo

Souter

et al. 2016

J Assist Reprod Genet

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, a TSH cut-off of 2.5 mIU/L or 4.5 mIU/L in women who underwent in vitro fertilization (IVF) [24]. or intrauterine insemination [25]. and it was not…”

Section: Main Issuementioning

confidence: 99%

Evaluation of Pregnancy and Thyroid Function

Chang-Eun

2018

Korean J Clin Lab Sci.

View full text Add to dashboard Cite

임신과 갑상선 기능의 평가 박창은 남서울대학교 임상병리학과, 분자진단연구소During early pregnancy, before the development of a functioning thyroid gland, thyroid stimulating hormone (TSH) is a very sensitive marker of thyroid dysfunction during pregnancy. Normal values have been modified during gestation with a downward shift. The fetus is influenced by the TSH supplied by the mother. TSH and free thyroxine (FT4) concentrations vary during pregnancy and conventional units can vary between laboratories. A downward shift of the TSH reference range occurs during pregnancy, with a decrease in both the lower and upper limits of maternal TSH, relative to the typical non-pregnant TSH reference range. Each laboratory produces its own reference TSH and FT4 concentrations because there are many different assays that yield different results in pregnancy. Therefore, automated immunoassays used for serum FT4 analysis are still used widely, but the important considerations discussed above must be noted. The use of population-based, trimester-specific reference ranges remains the best way to handle this issue The slight downward shift in the upper reference range of TSH occurring in the latter first trimester (7∼12 weeks) of pregnancy, typically not observed prior to 7 weeks. Their use indicates high or low levels in a quantitative manner independent of the reference ranges. These data highlight the importance of calculating population-based pregnancy-specific thyroid parameter reference intervals. A precision medicine initiative in this area will require the collection and analysis of a large number of genetic, biological, psychosocial, and environmental variables in large cohorts of individuals. Large prospective randomized controlled trials will be needed to resolve these controversies.

show abstract

“…However, a TSH cutoff of 2.5 IU/L or 4.5 IU/L in women who underwent in vitro fertilisation (FIV) (86) or intrauterine insemination (87) did not show differences in the rates of clinical pregnancy, delivery or miscarriage. These results are in consonance with the hypothesis that the risk of adverse pregnancy outcomes is lower in women with a relatively normal response to hCG (60) as must occur in successful cycles in assisted reproduction.…”

Section: Against Treating Subclinical Thyroid Dysfunctionmentioning

confidence: 98%

Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies

Velasco

Taylor

2018

European Journal of Endocrinology

View full text Add to dashboard Cite

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.

show abstract

Preconceptional thyroid-stimulating hormone levels and outcomes of intrauterine insemination among euthyroid infertile women

Cited by 47 publications

References 20 publications

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

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

Evaluation of Pregnancy and Thyroid Function

Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies

Contact Info

Product

Resources

About