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轻度评估的促甲状腺激素水平对首次新鲜胚胎移植的女性体外受精或卵胞浆内单精子注射结局的影响:来自中国的一项大型研究。

Impact of mildly evaluated thyroid-stimulating hormone levels on in vitro fertilization or intracytoplasmic sperm injection outcomes in women with the first fresh embryo transfer: a large study from China.

机构信息

Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, China.

出版信息

J Assist Reprod Genet. 2024 Mar;41(3):683-691. doi: 10.1007/s10815-023-03014-4. Epub 2024 Feb 26.

Abstract

PURPOSE

This study aimed to investigate the association between mild elevation of thyroid-stimulating hormone (TSH) levels and pregnancy outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments in women with the first fresh embryo transfer.

METHODS

Large single-center retrospective cohort study of 15,728 patients from January 2018 to December 2022 were enrolled in the analyses. Clinical pregnancy rates, live birth rates, miscarriage rates, and ectopic pregnancy rates were compared between the TSH levels < 2.5 mIU/L group (N = 10,932) and TSH levels ≥ 2.5 mIU/L group (N = 4796). Subgroup analysis was performed for patients with TSH levels ≥ 2.5 mIU/L, dividing them into the thyroid peroxidase antibody (TPO)-negative group (N = 4524) and the TPO-positive group (N = 272).

RESULTS

There were no significant differences in the aforementioned pregnancy outcomes between the TSH levels < 2.5 mIU/L group and TSH levels ≥ 2.5 mIU/L group. Similarly, no significant differences were observed in the pregnancy outcomes between the TPO-negative group and the TPO-positive group.

CONCLUSION

Mildly elevated pre-conception TSH levels in thyroid-normal infertile patients did not have an impact on pregnancy outcomes of IVF/ICSI treatments.

摘要

目的

本研究旨在探讨在首次新鲜胚胎移植的甲状腺刺激激素(TSH)水平轻度升高的女性中,与体外受精(IVF)或卵胞浆内单精子注射(ICSI)治疗的妊娠结局之间的关联。

方法

对 2018 年 1 月至 2022 年 12 月期间的 15728 名患者进行了大型单中心回顾性队列研究。比较了 TSH 水平<2.5mIU/L 组(N=10932)和 TSH 水平≥2.5mIU/L 组(N=4796)之间的临床妊娠率、活产率、流产率和异位妊娠率。对 TSH 水平≥2.5mIU/L 的患者进行了亚组分析,将其分为甲状腺过氧化物酶抗体(TPO)阴性组(N=4524)和 TPO 阳性组(N=272)。

结果

TSH 水平<2.5mIU/L 组和 TSH 水平≥2.5mIU/L 组之间在上述妊娠结局方面没有显著差异。同样,TPO 阴性组和 TPO 阳性组之间的妊娠结局也没有显著差异。

结论

甲状腺功能正常的不孕患者在受孕前 TSH 水平轻度升高,并不会对 IVF/ICSI 治疗的妊娠结局产生影响。

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