Laufer M R, Floor A E, Parsons K E, Kuntz K M, Barbieri R L, Friedman A J
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
J Assist Reprod Genet. 1995 Feb;12(2):93-6. doi: 10.1007/BF02211376.
To evaluate the frequency of abnormal prolactin and thyroid stimulating hormone (TSH) test results in ovulatory women with tubal factor infertility who were screened for in vitro fertilization (IVF).
Charts were identified from 112 ovulatory women with follicle stimulating hormone (FSH) < 20 mIU/ml who were diagnosed with tubal factor infertility and were screened for IVF with thyroid stimulating hormone (TSH) and prolactin levels. Women previously diagnosed with thyroid disease were subsequently excluded and 98 subjects remained. All subjects were determined to be ovulatory by biphasic basal body temperature (BBT) charts, luteal phase progesterone > 4 ng/ml, or endometrial biopsy revealing secretory endometrium. Results of cycle day 3 serum TSH and prolactin concentrations were recorded. The normal range for each test reflects the geometric mean +/- 2 standard deviations (i.e., 95% interval), as obtained from the reference laboratory. Under this construct, hypothesis tests were performed to determine whether or not our study population was consistent with the reference range of normal hormone levels. Under the null hypothesis (normal levels), we expected 5% of the TSH tests to be abnormal (i.e., high or low levels), and 2.5% of the prolactin tests to be abnormal (i.e., high levels). Exact bionomial confidence intervals and P-values were calculated. We also tested for age trend in the proportion of abnormal results.
Study subjects had an age range of 25-43. In the study group, 4 (0.041) out of the 98 women screened had abnormal TSH levels. Of these four abnormal TSH results, three were elevated (i.e., TSH > 4.6 microIU/ml) and one was low (i.e., TSH < 0.6 microIU/ml). The frequency of an abnormal TSH value was not significantly different from that expected from the reference laboratory normal values (95% CI 0.011, 0.101). Of the 98 subjects, 7 (0.071) had abnormal prolactin levels, which was significantly different from that expected from the reference laboratory normal values (95% CI 0.029, 0.142; P = 0.023). When stratified by age, there was no observed trend of abnormalities for TSH or prolactin levels with increasing age.
In ovulatory women presenting for IVF with tubal factor infertility, our results show that routine screening with a TSH test does not yield a significantly higher proportion of abnormal results than that expected from the reference laboratory normal values. However, prolactin level screening was found to yield a higher incidence of abnormal tests than expected from the reference laboratory normal values.
评估因输卵管因素不孕而接受体外受精（IVF）筛查的排卵功能正常女性中，催乳素和促甲状腺激素（TSH）检测结果异常的发生率。
从112名卵泡刺激素（FSH）<20 mIU/ml、诊断为输卵管因素不孕且接受了TSH和催乳素水平检测以进行IVF筛查的排卵功能正常女性的病历中进行筛选。先前被诊断患有甲状腺疾病的女性随后被排除，最终留下98名受试者。所有受试者均通过双相基础体温（BBT）图表、黄体期孕酮>4 ng/ml或子宫内膜活检显示分泌期子宫内膜来确定具有排卵功能。记录月经周期第3天血清TSH和催乳素浓度的结果。每项检测的正常范围反映了从参考实验室获得的几何平均值±2个标准差（即95%区间）。在此框架下，进行假设检验以确定我们的研究人群是否与正常激素水平的参考范围一致。在零假设（正常水平）下，我们预计5%的TSH检测结果异常（即高水平或低水平），2.5%的催乳素检测结果异常（即高水平）。计算精确的二项式置信区间和P值。我们还检测了异常结果比例的年龄趋势。
研究对象的年龄范围为25 - 43岁。在研究组中，98名接受筛查的女性中有4名（0.041）TSH水平异常。在这4个异常的TSH结果中，3个升高（即TSH>4.6 μIU/ml），1个降低（即TSH<0.6 μIU/ml）。TSH值异常的频率与参考实验室正常数值预期的频率无显著差异（95% CI 0.
