Effect of levothyroxine treatment on in vitro fertilization and pregnancy outcome in infertile women with subclinical hypothyroidism undergoing in vitro fertilization/intracytoplasmic sperm injection
Effect of levothyroxine treatment on in vitro fertilization and pregnancy outcome in infertile women with subclinical hypothyroidism undergoing in vitro fertilization/intracytoplasmic sperm injection
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DOI：
10.1016/j.fertnstert.2010.12.004
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发表时间：
2011-04-01
影响因子：
6.7
通讯作者：
Kang, Byung-Moon
中科院分区：
文献类型：
--
作者：
Kim, Chung-Hoon;Ahn, Jun-Woo;Kang, Byung-Moon
目的：探讨左旋甲状腺素（LT4）治疗对亚临床甲状腺功能减退的不孕患者行体外受精/胞浆内单精子注射（ICSI）的IVF结果和妊娠结局的有益影响。设计：前瞻性、随机试验。单位：大学附属不孕不育诊所。患者：共有64例伴有亚临床甲状腺功能减退症的不孕患者，定义为血清TSH水平升高与正常游离T4水平相关，且没有明显的甲状腺功能减退症状。干预：将患者随机分为LT4治疗组和对照组。对于LT4治疗组，从试管婴儿/ ICSI控制卵巢刺激的第一天开始给予50mg LT4。主要结局指标：体外受精结果和妊娠结局。结果：两组患者特征无明显差异。重组人卵泡刺激素用于控制卵巢刺激的总剂量和天数也相似。LT4处理组I级或II级胚胎数量显著高于对照组。两组临床单周期妊娠率差异无统计学意义。但LT4治疗组流产率明显低于对照组。LT4治疗组胚胎着床率和活产率显著高于对照组。在对照组中，流产亚组的甲状腺过氧化物酶抗体和甲状腺球蛋白抗体水平明显高于分娩亚组。结论：LT4治疗可改善亚临床甲状腺功能低下妇女IVF/ ICSI的胚胎质量和妊娠结局。[j] .中国农业科学（英文版），2011;35(5):444 - 444。(C) 2011年美国生殖医学学会。)
Objective: To investigate whether levothyroxine (LT4) treatment has beneficial effects on IVF results and pregnancy outcome in infertile patients with subclinical hypothyroidism undergoing IVF/ intracytoplasmic sperm injection (ICSI).Design: Prospective, randomized trial.Setting: University-affiliated infertility clinic.Patient(s): A total of 64 infertile patients with subclinical hypothyroidism, defined as an elevated serum TSH level associated with a normal free T4 level and without frank symptoms of hypothyroidism.Intervention(s): Patients were randomized into an LT4 treatment group or control group. For the LT4 treatment group, 50 mg LT4 was administered from the first day of controlled ovarian stimulation for IVF/ ICSI. MainOutcome Measure(s): Results of IVF and pregnancy outcome.Result(s): There were no differences in patient characteristics between the two groups. Total dose and days of recombinant human FSH used for controlled ovarian stimulation were also similar. The number of grade I or II embryos was significantly higher in the LT4 treatment group than in the control group. There was no significant difference in the clinical pregnancy rate per cycle between the two groups. However, the miscarriage rate was significantly lower in the LT4 treatment group than in the control group. Embryo implantation rate and live birth rate were significantly higher in the LT4 treatment group. In the control group, both thyroid peroxidase antibody and thyroglobulin antibody levels were significantly higher in the miscarried subgroup than in the delivered subgroup.Conclusion(s): LT4 treatment can improve embryo quality and pregnancy outcome in subclinical hypothyroid women undergoing IVF/ ICSI. (Fertil Steril (R) 2011;95:1650-4. (C) 2011 by American Society for Reproductive Medicine.)