Improved in vitro fertilization outcomes after treatment of subclinical hypothyroidism in infertile women.

Autor: Abdel Rahman AH; Department of Obstetrics and Gynecology, Alexandria University, Alexandria, Egypt., Aly Abbassy H, Abbassy AA
Jazyk: angličtina
Zdroj: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 2010 Sep-Oct; Vol. 16 (5), pp. 792-7.
DOI: 10.4158/EP09365.OR
Abstrakt: Objective: To assess the effect of treatment of maternal subclinical hypothyroidism on infertility outcome.
Methods: Between April 1, 2006, and April 22, 2007, we conducted a prospective, randomized trial in infertile women with subclinical hypothyroidism who elected to undergo in vitro at the Shatby University Hospital for Women in Alexandria, Egypt. Patients were randomly assigned to 2 groups: treatment group (group A) and placebo group (group B). Male-factor infertility was ruled out. One month before the assisted reproduction technology procedure, group A underwent levothyroxine treatment with a dosage of 50 to 100 mcg daily, while group B started placebo. All patients underwent controlled ovarian stimulation. Patients who achieved pregnancy were followed up throughout their pregnancy until delivery. Levothyroxine treatment and placebo were maintained throughout pregnancy in group A and group B, respectively.
Results: Mean thyrotropin value was significantly lower in group A than in group B (1.1 ± 0.3 mIU/L vs 4.9 ± 0.7 mIU/mL, respectively). Mean number of retrieved oocytes was similar in both groups (6.19 ± 0.74 [group A] vs 6.08 ± 0.79 [group B]). Miscarriage rate was significantly lower in group A than in group B (9% vs 13%, respectively), and the clinical pregnancy rate and delivery rate were significantly higher in group A than in group B (35% and 10% vs 26% and 3%, respectively), indicating that the quality, not the quantity, of retrieved oocytes was more important.
Conclusion: These preliminary data suggest that levothyroxine supplementation should be recommended to achieve clinical pregnancies in women with subclinical hypothyroidism who are undergoing in vitro fertilization-intracytoplasmic sperm injection.
Databáze: MEDLINE