Anatte E Karmon1, Maria Batsis2, Jorge E Chavarro3, Irene Souter2. 1. Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Reproductive Endocrinology and Infertility Division, Harvard Medical School, Boston, Massachusetts. Electronic address: akarmon@mgh.harvard.edu. 2. Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Reproductive Endocrinology and Infertility Division, Harvard Medical School, Boston, Massachusetts. 3. Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts.
Abstract
OBJECTIVE: To evaluate differences in intrauterine insemination (IUI) outcomes among euthyroid women with preconceptional thyroid-stimulating hormone (TSH) values in the normal (0.4-2.4 mIU/L) and high-normal (2.5-4.9 mIU/L) ranges. DESIGN: Cohort study. SETTING: A single fertility center. PATIENT(S): A total of 1,477 women who underwent 4,064 IUI cycles between the years 2004 and 2012. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Live birth, clinical pregnancy, spontaneous abortion (SAB), and IUI cycle parameters. RESULT(S): Cycles were categorized into 4 groups based on preconceptional TSH values: 0.40-1.36 mIU/L; 1.37-1.86 mIU/L; 1.87-2.49 mIU/L; and 2.50-4.99 mIU/L. No statistically significant differences were found in IUI cycle parameters, clinical pregnancy rates, or live births per initiated cycle among the 4 TSH groups. However, preconceptional TSH was inversely related to SAB and positively related to live birth among women who achieved a clinical pregnancy. In this group of women, cycles with TSH values between 2.5 and 4.9 mIU/L were related to lower odds of SAB (odds ratio: 0.32; 95% confidence interval: 0.16-0.65) and higher odds of live birth (odds ratio: 2.80; 95% confidence interval: 1.43-5.48) compared with cycles among women in the lowest TSH group. CONCLUSION(S): Among euthyroid patients, preconceptional TSH values in the high-normal range (between 2.5 and 4.9 mIU/L) are not associated with adverse IUI outcomes.
OBJECTIVE: To evaluate differences in intrauterine insemination (IUI) outcomes among euthyroid women with preconceptional thyroid-stimulating hormone (TSH) values in the normal (0.4-2.4 mIU/L) and high-normal (2.5-4.9 mIU/L) ranges. DESIGN: Cohort study. SETTING: A single fertility center. PATIENT(S): A total of 1,477 women who underwent 4,064 IUI cycles between the years 2004 and 2012. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Live birth, clinical pregnancy, spontaneous abortion (SAB), and IUI cycle parameters. RESULT(S): Cycles were categorized into 4 groups based on preconceptional TSH values: 0.40-1.36 mIU/L; 1.37-1.86 mIU/L; 1.87-2.49 mIU/L; and 2.50-4.99 mIU/L. No statistically significant differences were found in IUI cycle parameters, clinical pregnancy rates, or live births per initiated cycle among the 4 TSH groups. However, preconceptional TSH was inversely related to SAB and positively related to live birth among women who achieved a clinical pregnancy. In this group of women, cycles with TSH values between 2.5 and 4.9 mIU/L were related to lower odds of SAB (odds ratio: 0.32; 95% confidence interval: 0.16-0.65) and higher odds of live birth (odds ratio: 2.80; 95% confidence interval: 1.43-5.48) compared with cycles among women in the lowest TSH group. CONCLUSION(S): Among euthyroid patients, preconceptional TSH values in the high-normal range (between 2.5 and 4.9 mIU/L) are not associated with adverse IUI outcomes.
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