Baker Valerie L, Rone Heather M, Pasta David J, Nelson H Preston, Gvakharia Marina, Adamson G David
Fertility Physicians of Northern California, San Jose, CA, USA.
Am J Obstet Gynecol. 2006 Jun;194(6):1668-74; discussion 1674-5. doi: 10.1016/j.ajog.2006.03.040.
The aim of this study was to determine if pregnancy outcome for women undergoing in vitro fertilization is correlated with pre-conception thyroid-stimulating hormone level.
We performed a retrospective cohort study of in vitro fertilization cycles in our private practice with an initial positive serum human chorionic gonadotropin level and thyroid-stimulating hormone level available (n = 364). We examined whether or not birth outcome differed between cycles in which the thyroid-stimulating hormone was > 2.5 mIU/L compared with cycles with a thyroid-stimulating hormone level of < or = 2.5 mIU/L. Logistic regression was used to determine the association between thyroid-stimulating hormone level and spontaneous abortion rate.
Delivery outcome was available for 195 cycles, 36% of which had a thyroid-stimulating hormone level > 2.5. The gestational age at delivery was higher in cycles with a thyroid-stimulating hormone < or = 2.5 than for cycles with a thyroid-stimulating hormone > 2.5 (38.5 vs 38.0 weeks for singletons, 36.0 vs 34.6 weeks for twins, overall P = .012 for thyroid-stimulating hormone level). The mean birth weight for cycles with a thyroid-stimulating hormone < or = 2.5 was higher than for cycles with a thyroid-stimulating hormone > 2.5 (7.33 vs 6.78 lbs for singletons, P = .024 and 5.36 vs 4.83 lbs for twins, P = .023). Restricting analysis to cycles where the woman was not taking thyroid replacement did not change the overall conclusions. There was a trend toward increasing risk of miscarriage with increasing thyroid-stimulating hormone level in nondonor cycles, controlling for age and day 3 follicle-stimulating hormone level, but this trend did not reach statistical significance.
A pre-conception thyroid-stimulating hormone level > 2.5 mIU/L is associated with a lower gestational age at delivery and lower birth weight in women undergoing in vitro fertilization.
本研究旨在确定接受体外受精的女性的妊娠结局是否与受孕前促甲状腺激素水平相关。
我们对本私人诊所中血清人绒毛膜促性腺激素水平初步呈阳性且有促甲状腺激素水平数据的体外受精周期进行了一项回顾性队列研究（n = 364）。我们比较了促甲状腺激素>2.5 mIU/L的周期与促甲状腺激素水平≤2.5 mIU/L的周期的分娩结局是否存在差异。采用逻辑回归来确定促甲状腺激素水平与自然流产率之间的关联。
195个周期有分娩结局数据，其中36%的促甲状腺激素水平>2.5。促甲状腺激素≤2.5的周期的分娩孕周高于促甲状腺激素>2.5的周期（单胎分别为38.5周和38.0周，双胎分别为36.0周和34.6周，促甲状腺激素水平总体P = 0.012）。促甲状腺激素≤2.5的周期的平均出生体重高于促甲状腺激素>2.5的周期（单胎分别为7.33磅和6.78磅，P = 0.024；双胎分别为5.36磅和4.83磅，P = 0.023）。将分析限制在女性未服用甲状腺替代药物的周期，总体结论未改变。在非供体周期中，在控制年龄和第3天卵泡刺激素水平的情况下，随着促甲状腺激素水平升高，流产风险有增加趋势，但这一趋势未达到统计学显著性。
受孕前促甲状腺激素水平>2.5 mIU/L与接受体外受精的女性的较低分娩孕周和较低出生体重相关。
