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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