The impact of thyroid function on intrauterine insemination outcome - a retrospective analysis

被引:19
作者
Jatzko, Birgit [1 ]
Vytiska-Bistorfer, Elisabeth [1 ]
Pawlik, Alexandra [1 ]
Promberger, Regina [2 ]
Mayerhofer, Klaus [1 ]
Ott, Johannes [1 ]
机构
[1] Med Univ Vienna, Clin Dept Gynecol Endocrinol & Reprod Med, Dept Obstet & Gynecol, A-1090 Vienna, Austria
[2] Med Univ Vienna, Dept Surg, A-1090 Vienna, Austria
关键词
Intrauterine insemination; Hypothyroidism; Autoimmune thyroiditis; TSH; Target value; IN-VITRO FERTILIZATION; SUBCLINICAL HYPOTHYROIDISM; ANTITHYROID ANTIBODIES; OVARIAN STIMULATION; INFERTILE WOMEN; TSH LEVELS; PREGNANCY; DYSFUNCTION; AUTOIMMUNITY; MISCARRIAGE;
D O I
10.1186/1477-7827-12-28
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Hashimoto's thyroiditis is the most common endocrinopathy in premenopausal women, and is associated with various gynecological problems, including recurrent miscarriage and unexplained infertility. A possible influence of Hashimoto's thyroiditis on the success of intrauterine insemination seems likely, but has not been evaluated as yet. Therefore, the aim of our study was to retrospectively analyze the impact on intrauterine insemination outcome of thyroid function and markers suggestive for Hashimoto's thyroiditis. Methods: Retrospective cohort study in a tertiary care center of 540 women who underwent Intrauterine Insemination. The clinical pregnancy rate was the main outcome parameters. The following possible influencing factors were tested: thyroid-stimulating hormone (TSH); thyroid autoantibodies; age; body mass index; type of sterility (primary/secondary); parity; male factor; presence of PCO syndrome; ovulation induction; ovarian stimulation; and current thyroid medication. Results: The overall clinical pregnancy rate was 6.9% (37/540). Age, thyroid hormone supplementation for thyroidstimulating hormone (TSH) levels > 2.5 micro-IU/ml, and ovulation induction with HCG were significantly predictive in the multivariate analysis (p < 0.05) as influencing factors for the pregnancy rate after intrauterine insemination. Conclusions: Women undergoing intrauterine insemination seem to benefit from a strict thyroid hormone supplementation regimen in order to achieve lower TSH levels.
引用
收藏
页数:6
相关论文
共 32 条
[1]   The Potential Use of Intrauterine Insemination as a Basic Option for Infertility: A Review for Technology-Limited Medical Settings [J].
Abdelkader, Abdelrahman M. ;
Yeh, John .
OBSTETRICS AND GYNECOLOGY INTERNATIONAL, 2009, 2009
[2]   Intrauterine insemination [J].
Aboulghar, M. ;
Baird, D. T. ;
Collins, J. ;
Evers, J. L. H. ;
Fauser, B. C. J. M. ;
Lambalk, C. B. ;
Somigliana, E. ;
Sunde, A. ;
Tarlatzis, B. ;
Crosignani, P. G. ;
Devroey, P. ;
Diczfalusy, E. ;
Diedrich, K. ;
Fraser, L. ;
Geraedts, J. P. M. ;
Gianaroli, L. ;
Glasier, A. ;
Van Steirteghem, A. .
HUMAN REPRODUCTION UPDATE, 2009, 15 (03) :265-277
[3]   What is the best treatment option for infertile women aged 40 and over? [J].
Armstrong, Sarah ;
Akande, Valentine .
JOURNAL OF ASSISTED REPRODUCTION AND GENETICS, 2013, 30 (05) :667-671
[4]   Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death [J].
Benhadi, N. ;
Wiersinga, W. M. ;
Reitsma, J. B. ;
Vrijkotte, T. G. M. ;
Bonsel, G. J. .
EUROPEAN JOURNAL OF ENDOCRINOLOGY, 2009, 160 (06) :985-991
[5]  
Bensdorp AJ., 2007, Cochrane Database Syst Rev, V17
[6]   In Vitro Fertilization Outcomes in Treated Hypothyroidism [J].
Busnelli, Andrea ;
Somigliana, Edgardo ;
Benaglia, Laura ;
Leonardi, Marta ;
Ragni, Guido ;
Fedele, Luigi .
THYROID, 2013, 23 (10) :1319-1325
[7]   Increased prevalence of thyroid antibodies in euthyroid women with a history of recurrent in-vitro fertilization failure [J].
Bussen, S ;
Steck, T ;
Dietl, J .
HUMAN REPRODUCTION, 2000, 15 (03) :545-548
[8]   Subclinical hypothyroidism and pregnancy outcomes [J].
Casey, BM ;
Dashe, JS ;
Wells, CE ;
McIntire, DD ;
Byrd, W ;
Leveno, KJ ;
Cunningham, FG .
OBSTETRICS AND GYNECOLOGY, 2005, 105 (02) :239-245
[9]   Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline [J].
De Groot, Leslie ;
Abalovich, Marcos ;
Alexander, Erik K. ;
Amino, Nobuyuki ;
Barbour, Linda ;
Cobin, Rhoda H. ;
Eastman, Creswell J. ;
Lazarus, John H. ;
Luton, Dominique ;
Mandel, Susan J. ;
Mestman, Jorge ;
Rovet, Joanne ;
Sullivan, Scott .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2012, 97 (08) :2543-2565
[10]   Thyroid autoimmunity in patients with recurrent spontaneous miscarriages [J].
Dendrinos, S ;
Papasteriades, C ;
Tarassi, K ;
Christodoulakos, G ;
Prasinos, G ;
Creatsas, G .
GYNECOLOGICAL ENDOCRINOLOGY, 2000, 14 (04) :270-274