Influence of hypothyroidism on in vitro fertilization outcomes

نویسندگان

  • Lei Zhang
  • Xiuli Yang
  • Xiao Sun
  • Yang Xu
  • Qing Xue
  • Jing Shang
  • Yanrong Kuai
  • Sheng Wang
  • Zhenyu Huang
  • Ke Ma
  • Tao Lv
  • Xi Yang
  • Qinping Liao
چکیده

Purpose: To analyze whether the thyroid status is affecting in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes. Methods: In this retrospective cohort study, we reviewed the medical records of 426 infertile women who underwent IVF/ICSI cycles. Included were hypothyroid (HypoT-LT4) patients with serum thyroidstimulating hormone (TSH) concentrations > 4.0 μIU/mL, which were treated with levothyroxine (LT4) (n = 28), untreated subclinical hypothyroid (scHypoT) (n = 128), as well as euthyroid (euT) patients (n = 270). Measured parameters were total gonadotropin (Gn) dosage, luteinizing hormone (LH), estradiol and progesterone (P) serum concentrations on human chorionic gonadotropin (hCG) trigger day, number of retrieved oocytes, mature (metaphase II) oocytes, fertilization rate, the number of two pronuclei (2PN) embryos, top quality embryos on day 3 of development, number of embryos transferred, endometrial thickness as well as implantation, clinical pregnancy, miscarriage and ongoing pregnancy rates. Results: HypoT-LT4 women had significantly decreased implantation (P = 0.046) and ongoing pregnancy (P = 0.034) rates as well as increased pregnancy loss (P = 0.042) and chemical pregnancy rates (P = 0.035) compared to euT and scHypoT women. scHypoT patients had significantly decreased single clinical pregnancy (P = 0.038) and increased twin pregnancy (P = 0.034) rates compared to euT and HypoT-LT4 women. The percentages of transfer per retrieval cycles and βhCG positive transfer cycles, clinical pregnancy rates per transfer cycles, as well as ectopic pregnancy rates and the occurrence of ovarian hyperstimulation syndromes (OHSS) were similar among the 3 groups. Conclusions: HypoT-LT4 patients had low implantation and high pregnancy loss rates. There was no evidence that IVF/ICSI outcomes were impaired among scHypoT and euT patients.

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تاریخ انتشار 2016