Dataset Information

Positive effects of thyroid replacement therapy on assisted reproductive technology outcomes in women with subclinical hypothyroidism with positive thyroid peroxidase autoantibodies.

ABSTRACT:

Objective

To study the beneficial effects of thyroid replacement therapy (TRT) on pregnancy outcomes in patients with subclinical hypothyroidism (SCl hypoT) with respect to thyroid peroxidase (TPO) autoantibodies.

Design

Retrospective study of 706 patients.

Setting

Not applicable.

Patients

The study evaluated 706 patients, who were divided into 3 cohorts: euthyroid patients, with pre-in vitro fertilization thyroid-stimulating hormone levels of <2.5 μIU/mL; patients with SCl hypoT, defined as thyroid-stimulating hormone levels of >2.5 μIU/mL and <4 μIU/mL, who were not treated; and patients with SCl hypoT who received TRT. The 3 cohorts were further subclassified into 2 groups, each based on TPO antibody levels.

Interventions

The cohorts were compared for the effects of TRT on pregnancy outcomes.

Main outcome measures

Identification of effects of TRT on assisted reproductive technology outcomes.

Results

Patients with SCl hypoT had significantly fewer positive pregnancy outcomes than euthyroid patients. Importantly, low-dose TRT was found to be beneficial in improving IVF success and pregnancy outcomes in patients with SCl hypoT. The original cohort of patients, further classified into 2 subgroups on the basis of antithyroid (TPO) antibodies, showed that low-dose TRT was associated with improved pregnancy outcomes in women with SCl hypoT and TPO-positive antibodies.

Conclusions

Our findings demonstrate that low-dose TRT may be beneficial in improving in vitro fertilization success and pregnancy outcomes in women with SCl hypoT and TPO-positive antibodies.

SUBMITTER: Arora H

PROVIDER: S-EPMC8978068 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Positive effects of thyroid replacement therapy on assisted reproductive technology outcomes in women with subclinical hypothyroidism with positive thyroid peroxidase autoantibodies.

Arora Himanshu H Collazo Ineabelle I Palmerola Katherine L KL Parmar Madhumita M Narasimman Manish M Hendon Nicholas N Eisermann Juergen J Bustillo Maria M

F&S reports 20211124 1

<h4>Objective</h4>To study the beneficial effects of thyroid replacement therapy (TRT) on pregnancy outcomes in patients with subclinical hypothyroidism (SCl hypoT) with respect to thyroid peroxidase (TPO) autoantibodies.<h4>Design</h4>Retrospective study of 706 patients.<h4>Setting</h4>Not applicable.<h4>Patients</h4>The study evaluated 706 patients, who were divided into 3 cohorts: euthyroid patients, with pre-in vitro fertilization thyroid-stimulating hormone levels of <2.5 μIU/mL; patients w ...[more]

PMID: 35386496

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Project description:BackgroundSome clinicians used levothyroxine (LT4) treatment for mild subclinical hypothyroidism (SCH) pregnant women (2.5 < thyroid-stimulating hormone (TSH) ≤ the pregnancy-specific reference range with normal free thyroxine (FT4) level) with thyroid peroxidase antibody negative (TPOAb-), although the recent clinical guideline did not recommend it. It is unknown whether LT4 treatment for pregnant women with mild SCH and TPOAb- have impact on fetal growth. Therefore, the aim of the study was to investigate the effect of LT4 treatment on fetal growth and birth weight among mild SCH pregnant women with TPOAb-.MethodsThis was a birth cohort study including 14,609 pregnant women between 2016 and 2019 in Tongzhou Maternal and Child Health Hospital of Beijing, China. Pregnant women were divided into 3 groups as follows: Euthyroid (n = 14,285, 0.03 ≤ TSH ≤ 2.5mIU/L, normal FT4), TPOAb-; Untreated mild SCH with TPOAb- (n = 248, 2.5 < TSH ≤ 2.9mIU/L, normal FT4, without LT4 treatment); Treated mild SCH with TPOAb- (n = 76, 2.5 < TSH ≤ 2.9mIU/L, normal FT4, with LT4 treatment). The main outcome measures were Z-scores of fetal growth indicators (abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), head circumference (HC), estimated fetal weight (EFW)), fetal growth restriction (FGR) and birth weight.ResultsThere was no difference in fetal growth indicators and birth weight between the untreated mild SCH women with TPOAb- and the euthyroid pregnant women. But the HC Z-score was lower in the LT4 treated mild SCH women with TPOAb-, compared with the euthyroid pregnant women (β = -0.223, 95%CI: -0.422, -0.023). The LT4 treated mild SCH women with TPOAb- had lower fetal HC Z-score (β = -0.236, 95%CI: -0.457, -0.015), compared with the untreated mild SCH women with TPOAb-.ConclusionsWe observed that LT4 treatment for mild SCH with TPOAb- was associated with decreased fetal HC, which was not observed for untreated mild SCH women with TPOAb-. The adverse effect of LT4 treatment for mild SCH with TPOAb- provided new evidence for the recent clinical guideline.

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Dataset Information

Positive effects of thyroid replacement therapy on assisted reproductive technology outcomes in women with subclinical hypothyroidism with positive thyroid peroxidase autoantibodies.

Objective

Design

Setting

Patients

Interventions

Main outcome measures

Results

Conclusions

Publications

Positive effects of thyroid replacement therapy on assisted reproductive technology outcomes in women with subclinical hypothyroidism with positive thyroid peroxidase autoantibodies.

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