Evaluation of Reproductive Outcome in Infertile Hypothyroid Women on Thyroxine Therapy (2025)

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“…Given the above, there is a need to verify the possible effects of TD on the clinical outcomes of ARTs to establishing protocols that will improve the clinical management of patients with TDs to increase the success rates of these techniques ( Unuane & Velkeniers, 2020 ). In addition, there is a shortage of studies that recommend or contraindicate the use of routine therapies specific to women with TD who have impaired fertility and are seeking to become pregnant with the aid of ARTs ( Wadhwa et al ., 2020 ). Therefore, the present study aims to evaluate from a systematic literature review the deleterious activity of TDs in the clinical outcome of ARTs, in addition to investigating the influence of the most used drugs for treatment in the protocols of ART.…”

confidence: 99%

et al. 2023

Objective To verify from a systematic literature review the possible effects of thyroid diseaseson assisted reproduction techniques. Data sources The studies were analyzed from the PubMed, Cochrane Library, LILACS databases. Selection of studies The articles selected for the review included: cross-sectional studies, cohort studies,and clinical trials that addressed the proposed theme and which were published withinthe period stipulated from January 1, 2012, to March 5, 2022, in English, Portuguese andSpanish. These would later have to go through stages of inclusion as a framework of thetype of study and exclusion criteria that were review articles, case reports, abstracts,articles with animal models, and duplicate articles and letters to the editor. Data collection Author’s name; Number of patients; Clinical outcome; Use of drugs; Control group (incase it had); Clinical outcome. Data synthesis In in vitro fertilization and intracytoplasmic sperm injection it wasverified that thyroid diseases can lead to effects such as a reduction in the rate ofrecovered oocytes, a decrease in the number of embryos, lower pregnancy rates, andincreased chances of congenital anomalies in these patients and a reduction in the rateof implantation. Levothyroxine can increase the number of cycle cancellations. Conclusions Thyroid diseases may have deleterious effects on the clinical outcome of invitro fertilization and intracytoplasmic sperm injection.

Background The serum TSH level of PCOS patients was higher than that of the general female population. For patients with thyroid dysfunction, the abnormal TSH level is negatively related to the outcomes of assisted reproductive technology, but for PCOS patients with normal thyroid function, the effect of TSH level on outcomes of in vitro fertilization has not been reported. In this study, PCOS patients with normal thyroid function were included in this study to evaluate the effect of TSH on the outcomes of IVF-ET. Methods A retrospective cohort study was conducted to analyze the clinical data of 3190 patients who underwent IVF-ET in the Department of Human Reproductive Center of Renmin Hospital Hubei University of Medicine from January 2017 to July 2021, including 594 PCOS patients and 2595 non PCOS patients. The IVF-ET outcomes between the two groups were compared; Multi-factor linear regression analysis was used to analyze the correlation between the related variables and the oocyte maturation of PCOS patients; The ROC curve of the effect of TSH on oocyte maturation in PCOS patients was drawn. The PCOS patients were divided into TSH < 2.98 group (n = 454) and TSH ≥ 2.98 group (n = 141) according to ROC threshold TSH 2.98, and the outcomes were compared. Results TSH level in PCOS group was significantly higher than that in non-PCOS group (2.42 ± 0.86 vs 2.00 ± 0.89 UU / ml, P < 0.01), and the oocyte maturation rate and 2PN fertilization rate in PCOS group were lower than those in non-PCOS group (90.9% vs 92.4%, P = 0.02) (84.57% vs 86.77%, P = 0.02). There was no significant difference in cleavage rate and high-quality embryo rate between the two groups (P > 0.05); There was no difference in clinical pregnancy rate, abortion rate, ectopic pregnancy rate and live birth rate between the two groups (P > 0.05). Multi-factor linear regression analysis showed that TSH was negatively correlated with oocyte maturation in PCOS patients [β = -0.124, P = 0.013,95%CI (-0.027 ~ -0.003)]; The oocyte maturation rate in TSH < 2.98 group was significantly higher than that in TSH ≥ 2.98 group (91.7% vs 88.2%, P = 0.001). Conclusion The TSH level of PCOS patients with normal thyroid function is higher than that of normal people, and it is negatively correlated with the oocyte maturation in in-vitro fertilization. The ROC curve showed that when TSH > 2.98uIU/ml, the possibility of immature oocytes was higher (specificity 28.9%, sensitivity 83.0%).

The objective: to study the main clinical aspects of infertility in women with various variants of thyroid pathology.Materials and methods. A clinical screening examination of 496 women with infertility (main group), of which 238 were diagnosed the various thyroid pathologies, and 80 women with thyroid pathology without reproductive function disorders (control group) was carried out.Results. Primary infertility was diagnosed in 49.4 % of examined women, and secondary infertility – in 50.6 % of patients. Female infertility was diagnosed in 327 (65.9 %) patients, male infertility in 126 (25.4%) women; infertility of unknown genesis was established during the examination of 43 married couples (8.7 %). In the structure of the causes of female infertility, the tubal-peritoneal factor prevailed (37 %), the frequency of external genital endometriosis was 36.4 %, the endocrine factor – 23.2 %, and the uterine factor – 3.4 %. A combination of infertility factors was determined in 23.8 % of women. The results of studying the reproductive history showed that 251 patients with secondary infertility have a history of 279 pregnancies. The positive obstetrical outcomes such as term uncomplicated childbirth was established only in 48 (19.1 %) patients; the first term birth occurred in 28 (11.1%) women, the second birth – in 16 (6.4 %) patients. Pregnancy ended with premature birth in 27 (10.7 %) women, induced abortions – in 41 (16.3%), spontaneous abortions – in 58 (23.1 %), 41of them (16.3 %) had one spontaneous abortion; missed abortion – in 57 (22.7 %) patients, ectopic pregnancy – in 19.1 %.A comparative evaluation of thyroid screening results in infertile and fertile women demonstrated that the prevalence of thyroid pathology in infertile patients was 3.8 times higher compared to fertile women (48 % and 12.5 %, respectively). In the structure of the thyroid gland pathology in both groups the presence of antibodies to thyroperoxidase combined with echo signs of autoimmune thyroiditis prevailed, which is 2.8 times more often diagnosed in the group of infertile women compared to fertile women (24 % and 8.7 %, respectively).Conclusions. The prevalence of thyroid pathology in patients with infertility is 3.8 times higher compared to fertile women. In women with secondary infertility pregnancy loss in the I trimester of gestation is dominated in the structure of reproductive outcomes.