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Relationship between maternal serum thyroid stimulating hormone and in vitro fertilization-conceived pregnancy outcomes
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Coussa, Ayla, Barber, Thomas M., Khrait, Zakwan, Cheaib, Samer and Hayder, A. Hasan (2022) Relationship between maternal serum thyroid stimulating hormone and in vitro fertilization-conceived pregnancy outcomes. Journal of Human Reproductive Sciences, 15 (2). pp. 163-170. doi:10.4103/jhrs.jhrs_168_21 ISSN 0974-1208.
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WRAP-Relationship-maternal-serum-thyroid-in-vitro-fertilization-conceived-pregnancy-outcomes-2022.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial-Share Alike 4.0. Download (1170Kb) | Preview |
Official URL: https://doi.org/10.4103/jhrs.jhrs_168_21
Abstract
Background: Thyroid dysfunction impairs female fertility and pregnancy outcome. Optimal preconception and gestational TSH level is still debatable in IVF-conceived pregnancies. Aims: To explore the relationships of IVF success and pregnancy outcomes with maternal serum levels of TSH (at both preconception and 12-week IVF-conceived pregnancy). Also, to confirm or refute the recommended TSH level ≤2.5μIU/mL. Setting and Design: Retrospective cohort. Material and Methods: 158 IVF-conceived pregnant women and 117 age-matched controls non-pregnant (≤39years, BMI 18.5-38kg/m2) were recruited. Preconception and 12-week IVF-conceived pregnancy serum samples were analysed for reproductive hormones, fasting glucose, insulin and TSH levels. Data of pregnant women at 28 weeks for GDM screening (75-gram OGTT) and up until delivery were included. Statistical Analysis: Binary logistic regression used to predict association between preconception TSH levels and IVF success, and pregnancy outcomes. Association of delta change of hormones was determined with linear regression. Significance level P≤0.05 with 95% confidence interval (CI). Results: Overall, median (IQR) age was 32(6)years, BMI 25.4(6.9)kg/m2, HbA1c 5.2(0.52)% and TSH 1.82(1.4)μIU/mL. There was no significant association between preconception TSH level and IVF success rate. During the first trimester of IVF-conceived pregnancy, delta change in TSH level was associated with that of progesterone (P=0.03). 12-week gestation TSH level did not predict adverse pregnancy outcomes (i.e. onset of GDM, delivery type and premature delivery); but a higher TSH level predicted earlier delivery in weeks. There was a higher risk of delivery by caesarean section when TSH>2.5μIU/mL. Conclusion: Variation of maternal TSH within normal range (0.4-4.0μIU/mL) at preconception and 12-week gestation has no predictive effect on IVF success and pregnancy outcomes in IVF-pregnancy. Our data provide no support for a recommended preconception TSH level ≤2.5μIU/mL in IVF-conceived pregnancy, but rather promote a preconception TSH level within normal range.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine R Medicine > RG Gynecology and obstetrics |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Thyroid gland -- Diseases, Fertilization in vitro, Human | ||||||
| Journal or Publication Title: | Journal of Human Reproductive Sciences | ||||||
| Publisher: | Medknow Publications | ||||||
| ISSN: | 0974-1208 | ||||||
| Official Date: | 1 June 2022 | ||||||
| Dates: |
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| Volume: | 15 | ||||||
| Number: | 2 | ||||||
| Page Range: | pp. 163-170 | ||||||
| DOI: | 10.4103/jhrs.jhrs_168_21 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Date of first compliant deposit: | 21 July 2022 | ||||||
| Date of first compliant Open Access: | 21 July 2022 | ||||||
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