Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Acta Obstet Gynecol Scand. 2019 Jul;98(7):929-936. doi: 10.1111/aogs.13563. Epub 2019 Mar 4.
Thyroid disorders have been associated with adverse reproductive outcome. Whether the preconceptional level of thyrotropin (TSH) in euthyroid women impacts on in vitro fertilization (IVF) outcome has been debated. This study reports the outcome of first IVF cycle in euthyroid women in relation to TSH level.
A retrospective study was conducted in women referred for fertility treatment in the period 1 January 2012 until 31 March 2014. Among the exclusion criteria were thyroid medication at referral and comorbidities. TSH was measured as part of the fertility workup, and women were followed until pregnancy loss or live birth. Outcome as well as patient characteristics were prospectively collected from a treatment database.
A total of 623 euthyroid women underwent their first IVF cycle. The live birth rate was 27.0% (n = 168). Comparing women with a preconceptional TSH level above vs below 2.5 mIU/L, we found lower odds for clinical pregnancy (adjusted odds ratio [aOR] 0.52; 95% CI 0.29-0.95), and lower odds for live birth (aOR 0.53; 95% CI 0.29-0.99).
A preconceptional TSH level >2.5 mIU/L was associated with lower odds for clinical pregnancy and live birth in euthyroid healthy women undergoing first IVF cycle.
甲状腺疾病与不良生殖结局有关。甲状腺功能正常的女性在受孕前的促甲状腺激素（TSH）水平是否会影响体外受精（IVF）的结果一直存在争议。本研究报告了甲状腺功能正常的女性首次 IVF 周期与 TSH 水平的关系。
对 2012 年 1 月 1 日至 2014 年 3 月 31 日期间因生育治疗而就诊的女性进行了回顾性研究。排除标准包括就诊时甲状腺药物治疗和合并症。TSH 作为生育检查的一部分进行测量，随访至妊娠丢失或活产。结果和患者特征从治疗数据库中前瞻性收集。
共有 623 名甲状腺功能正常的女性进行了首次 IVF 周期。活产率为 27.0%（n=168）。比较受孕前 TSH 水平高于和低于 2.5 mIU/L 的女性，我们发现临床妊娠的几率较低（调整后的优势比[aOR]0.52；95%CI 0.29-0.95），活产的几率也较低（aOR 0.53；95%CI 0.29-0.99）。
甲状腺功能正常的健康女性在进行首次 IVF 周期时，受孕前 TSH 水平>2.5 mIU/L 与临床妊娠和活产的几率较低相关。
