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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 EuthyroidGroup B Hypothyroid
Age (Yrs)<302423
30-352627
EducationUndergraduate2224
Postgraduate2826
OccupationNot working1922
Working3128
Duration of infertility< 5 years2524
> 5 years2526
BMI (Kg/m2)<252422
>252628

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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