Subclinical Hypothyroidism and Infertility

Bohnet, H. G.; Fiedler, Kai; Leidenberger, Freimut A.

doi:10.1016/s0140-6736(81)91506-3

Cited by 93 publications

(35 citation statements)

References 5 publications

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“…The percentage of women seen for in vitro fertilization (IVF) with increased TSH levels is thought to be higher than that in the general population, although the exact proportion remains unclear due to differences in study design, patient selection, and demographic variations (10)(11)(12). Women with subclinical hypothyroidism, undergoing IVF, were found to have lower implantation and live birth rates, and an increased miscarriage rate compared to women with the same diagnosis who were treated with empiric levothyroxine during IVF (13).…”

Section: Introductionmentioning

confidence: 99%

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In Vitro Fertilization Pregnancy Rates in Levothyroxine-Treated Women with Hypothyroidism Compared to Women without Thyroid Dysfunction Disorders

Scoccia¹,

Demir²,

Fierro³

et al. 2012

Thyroid

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Background: Untreated hypothyroidism can lead to ovulatory dysfunction resulting in oligo-amenorrhea. Treatment with levothyroxine can reverse such dysfunction and thus should improve fertility. The purpose of this retrospective study was to assess whether in vitro fertilization (IVF) pregnancy rates differ in levothyroxinetreated women with hypothyroidism compared to women without thyroid dysfunction/disorders. Methods: Treated hypothyroid and euthyroid women undergoing IVF at an academic IVF center were studied after Institutional Review Board approval. Women with hypothyroidism were treated with levothyroxine 0.025-0.15 mg/day for at least 3 months to maintain baseline thyrotropin (TSH) levels of 0.35-4.0 lU/mL prior to commencing IVF treatment (HYPO-Rx group). Causes of infertility were similar in both groups with the exception of male factor, which was more common in the HYPO-Rx group. The main outcomes studied were implantation rate, clinical pregnancy rate, clinical miscarriage rate, and live birth rate. Results: We reviewed the first IVF retrieval cycle performed on 240 women aged 37 years or less during the period January 2003 to December 2007. Women with treated hypothyroidism (n = 21) had significantly less implantation, clinical pregnancy, and live birth rates than euthyroid women (n = 219). Conclusions: We conclude that, despite levothyroxine treatment, women with hypothyroidism have a significantly decreased chance of achieving a pregnancy following IVF compared to euthyroid patients. A larger prospective study is necessary to assess confounding variables, confirm these findings, and determine the optimal level of TSH prior to and during controlled ovarian hyperstimulation for IVF.

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Section: Introductionmentioning

confidence: 99%

“…Treatment of hypothyroidism with levothyroxine usually restores a normal menstrual pattern, reverses hormonal alterations, and improves fertility (7,8,10). However, some women with treated hypothyroidism still fail to conceive and seek infertility treatment, including controlled ovarian hyperstimulation (COH) and/or IVF.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Fertilization Pregnancy Rates in Levothyroxine-Treated Women with Hypothyroidism Compared to Women without Thyroid Dysfunction Disorders

Scoccia¹,

Demir²,

Fierro³

et al. 2012

Thyroid

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“…This association of hypothyroidism for infertility was due to deficiency of iodine associated with low intake in developing countries. 5 Most of the studies reported that mild iodine deficiency is associated with more hyperthyroidism and less hypothyroidism in the population. 6 Few of the studies reported the prevalence of hypothyroidism is higher in pregnant woman than nonpregnant woman.…”

Section: Discussionmentioning

confidence: 99%

A study of thyroid profile in cases of primary infertility attending a tertiary care hospital of south India

Nirakari

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Infertility is a rising major problem affecting more than 50 million couples globally every year. Endocrine as well as immune system abnormalities can impair the fertility. Most of the studies globally indicated association of infertility with multiple factors like stress, luteal phase defects, structural and functional reproductive disturbances. Many infertile women with thyroid dysfunction had associated hyperprolactinemia with increases TSH in ovulatory dysfunction. The aim of the present study was to determine the association of hypo and hyperthyroidism with infertility among cases of primary infertility in women.Methods: A cross sectional study was conducted among the patients attending the infertility clinic for the first time. The study was approved by the institutional ethical committee and the study was carried as per the guidelines of the ethical committee. The serum levels of T3, T4 and TSH were estimated and Prolactin in cases where necessary by Chemiluminiscence immunoassay. The data was analyzed by using the unpaired “t” test. A ‘p’ value <0.05 was considered significant.Results: 285 cases were enrolled and majority (38.6%) was in 31-34 age groups with mean age of 24.2± 1.6 years. 30.53% were found with thyroid dysfunction. Majority (16.49%) were found with subclinical hypothyroid, followed in order by primary hypothyroid (9.82%), subclinical hyperthyroid (2.11%), primary hyperthyroid (1.05%), secondary hypothyroid (0.70%) and secondary hyperthyroid (0.35%).Conclusions: To conclude, thyroid dysfunction is a common cause of infertility and can be easily managed by correcting the levels of thyroid hormones. Present study suggests that thyroid replacement therapy in subclinical hypothyroidism at an early stage is justified in infertile women. Borderline variations in TSH levels should not be ignored in infertile women who are otherwise asymptomatic for subclinical hypothyroidism. Hence for better management of cases of primary infertility studies with large sample size and long term follow up are required to validate and justify the variation in TSH and prolactin levels.

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“…Hypothyroidism results in changes in cycle length, amount of bleeding, and usually is associated with abnormal menstrual cycles characterized mainly by polymenorrhea and anovulatory cycles (Krassas et al, 1999). Also subclinical hypothyroxinemia can be associated with short luteal phase and insufficient progesterone secretion (Bohnet et al, 1981); similar pictures are present in a variety of situations characterized by low T3 levels (malnutrition, chronic illness, exercise), known as "nonthyroidal illness" (De Groot, 2006).…”

Section: Introductionmentioning

confidence: 94%

“…Many studies have been performed also in subclinical hypothyroidism (SCH); the prevalence of SCH in infertile women was 11% in one study (Bohnet et al, 1981), but not considered as an infertility factors by others (Bals-Pratsch et al, 1997). A positive correlation was found in early follicular phase between basal TSH, LH and T; moreover women with elevated TSH response to TRH had lower pregnancy rate than women with normal TSH response (Gerhard et al, 1991).…”

Section: Hypothyroidism and Female Infertilitymentioning

confidence: 99%