Julian A Gingold1,2,3, Kelly Zafman2, Jorge Rodriguez-Purata1, Michael C Whitehouse1, Joseph A Lee1, Benjamin Sandler1,2, Alan B Copperman1,2. 1. a Reproductive Medicine Associates of New York , New York , NY , USA. 2. b Department of Obstetrics , Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai , New York , NY , USA , and. 3. c Obstetrics/Gynecology and Women's Health Institute, Cleveland Clinic Foundation , Cleveland , OH , USA.
Abstract
INTRODUCTION: The upper limit of normal TSH has been revised from 5 mIU/L to 2.5 mIU/L. We sought to evaluate IVF patients and the association between abnormal TSH and early pregnancy loss. METHODS: A retrospective study of patients who had TSH levels measured within the 2 weeks prior to their fresh autologous IVF cycles (2002-2014). Cohorts were stratified by oocyte age (<35, [35-38), [38-41), [41-43) and ≥43 years), and TSH level [(0-0.5], (0.5-2.5], (2.5-5], and (5-23) mIU/L]. Patients were followed until pregnancy loss or delivery. Model was assessed by chi-square of ANOVA with significance at p < 0.05. RESULTS: TSH was abnormally elevated (>5 mIU/L), mildly elevated ((2.5-5] mIU/L) or suppressed (≤0.5 mIU/L) in 46, 317 and 65 of the 1201 total cycles, respectively. Treatment resulted in 630 pregnancies, 524 clinical pregnancies and 409 deliveries. Pregnancy loss rates were increased in patients ≥38 yo (p < 0.001) but not [35-38) yo (p = 0.40) compared with those <35 yo. Early pregnancy loss rate was not associated with TSH level (p > 0.30) compared with euthyroid patients after adjusting for oocyte age. CONCLUSION: Early pregnancy loss rate in IVF patients appears to have no relation to recent TSH levels.
INTRODUCTION: The upper limit of normal TSH has been revised from 5 mIU/L to 2.5 mIU/L. We sought to evaluate IVFpatients and the association between abnormal TSH and early pregnancy loss. METHODS: A retrospective study of patients who had TSH levels measured within the 2 weeks prior to their fresh autologous IVF cycles (2002-2014). Cohorts were stratified by oocyte age (<35, [35-38), [38-41), [41-43) and ≥43 years), and TSH level [(0-0.5], (0.5-2.5], (2.5-5], and (5-23) mIU/L]. Patients were followed until pregnancy loss or delivery. Model was assessed by chi-square of ANOVA with significance at p < 0.05. RESULTS:TSH was abnormally elevated (>5 mIU/L), mildly elevated ((2.5-5] mIU/L) or suppressed (≤0.5 mIU/L) in 46, 317 and 65 of the 1201 total cycles, respectively. Treatment resulted in 630 pregnancies, 524 clinical pregnancies and 409 deliveries. Pregnancy loss rates were increased in patients ≥38 yo (p < 0.001) but not [35-38) yo (p = 0.40) compared with those <35 yo. Early pregnancy loss rate was not associated with TSH level (p > 0.30) compared with euthyroid patients after adjusting for oocyte age. CONCLUSION: Early pregnancy loss rate in IVFpatients appears to have no relation to recent TSH levels.
Entities:
Keywords:
Early pregnancy loss; euthyroid; in vitro fertilization; subclinical hypothyroidism; thyroid stimulating hormone
Authors: R Vissenberg; V D Manders; S Mastenbroek; E Fliers; G B Afink; C Ris-Stalpers; M Goddijn; P H Bisschop Journal: Hum Reprod Update Date: 2015-01-28 Impact factor: 15.610
Authors: Konstantinos A Toulis; Dimitrios G Goulis; Christos A Venetis; Efstratios M Kolibianakis; Roberto Negro; Basil C Tarlatzis; Ioannis Papadimas Journal: Eur J Endocrinol Date: 2009-12-02 Impact factor: 6.664