Comparison of reproductive outcomes in subclinical hypothyroidism women with high‐normal versus low‐normal thyroid‐stimulating hormone levels after treatment with levothyroxine
Authors' conclusion
High-normal TSH levels did not have adverse effects on clinical and obstetric outcomes when compared with low-normal TSH levels after LT4 treatment. However, whether it is appropriate to set 2.5 mIU/L as the goal of treatment before IVF/ICSI remains to be determined in further well-designed studies.
Study context
- Population
- Infertile women with subclinical hypothyroidism (SCH) treated with levothyroxine (LT4), undergoing first in vitro fertilisation and embryo transfer (IVF-ET) cycle548 LT4-treated
- Participants
- 6,002 women
- Exposure
- High-normal vs low-normal thyroid-stimulating hormone (TSH) after LT4 treatment
- High-normaln = 167
- Low-normaln = 129reference
- Outcome
- Clinical pregnancy, miscarriage and live birth rates
Main finding
As reported in the abstract
High-normal vs Low-normalEstimate (95% CI)P value
Adjusted by age, AMH, infertility duration, transferred embryos, LT4 dose and duration
aOR (miscarriage) 2.27(0.77–6.69)
P = 0.14Clinical pregnancy, miscarriage and live birth rates
aOR (clinical pregnancy) 1.15(0.70–1.89)
P = 0.57Clinical pregnancy, miscarriage and live birth rates
aOR (live birth) 0.97(0.60–1.59)
P = 0.92- Clinical pregnancy, miscarriage and live birth rates comparable between low-normal and high-normal
- all p > .05
Observational data: associations, not effects.
Further findings
- Similar obstetric outcomes between low-normal and high-normal TSH after LT4, and between euthyroid and LT4-treated
- all p ≥ .05
Original publication
Comparison of reproductive outcomes in subclinical hypothyroidism women with high‐normal versus low‐normal thyroid‐stimulating hormone levels after treatment with levothyroxine. Clin Endocrinol (Oxf). Published 17 August 2022. doi:10.
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