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IVF outcome in females with hypothyroidism with strict control of TSH levels

Hypothyroidism (Low Fertility)

plasma concentrations of estrogens and androgens

  • Deficient LH secretion
  • Reduced libido and anovulation

During IVF & Pregnancy

Strict control of TSH levels

Objective:

To assess the IVF outcome in infertile females with hypothyroidism after the strict control of TSH levels

Methods:

    • Duration of study – 6 months
    • Subject – 100 infertile females
      • Group A – 50 females (euthyroid)
      • Group B – 50 females (hypothyroidism)
        • TSH levels > 8 mIU/L in initial infertility work up)
    • Levothyroxine 50 mcg
    • TSH repeated after 7 to 10 days
    • Start of stimulation, before ET and on Beta HCG days.
    • Dose titration according to levels
    • Embryo transfer planned when TSH levels <4 mIU/L
Group A Euthyroid Group B Hypothyroid
Age (Yrs) <30 24 23
30-35 26 27
Education Undergraduate 22 24
Postgraduate 28 26
Occupation Not working 19 22
Working 31 28
Duration of infertility < 5 years 25 24
> 5 years 25 26
BMI (Kg/m2) <25 24 22
>25 26 28

Limitations

Retrospective

Need to compare pregnancy outcome with poorly controlled group.

Did not study role of TPO

Did not study miscarriage rate

Conclusion:

Hypothyroidism

      • Increased risk of infertility
      • Results in IVF failure

Conclusions

Tight Control of TSH levels in Hypothyroid women undergoing IVF leads to similar pregnancy rates as Euthyroid patients

First ever study of this kind to the best of our knowledge

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