Incidence of elevation of serum thyroid-stimulating hormone during controlled ovarian hyperstimulation for in vitro fertilization
Abstract
Objective To evaluate the rate of euthyroid women encountering an elevation of serum TSH above the threshold of 2.5 mIU/L during controlled ovarian hyperstimulation (COH) for IVF. Study design Six-month prospective cohort study on 175 consecutive euthyroid women undergoing their first IVF cycle. Serum TSH assessments were performed before COH, at the time of hCG administration and at +16 days after hCG administration. Women were eligible if serum TSH tested the month preceding the IVF cycle was 0.4-2.5 mIU/L. A history of thyroid disorders was an exclusion criterion. Results Serum concentrations of TSH at the three scheduled assessments were 1.5±0.5, 2.2±1.0 and 2.1±1.1 mIU/L, respectively. A statistically significant increase occurred between basal levels and levels at the time of hCG administration (p<0.001). Afterwards, levels remained stable (p=0.49). Serum TSH at the time of hCG administration exceeded the threshold of 2.5 mIU/L in 61 subjects, corresponding to 35% (95% CI: 28-42%). At +16 days after hCG administration, this event was observed in 47 subjects (27%, 95% CI: 21-34%). Baseline characteristics of women who did and did not exceed the threshold were similar apart from basal serum TSH, which was higher in the former group. The OR was 7.6 (95%CI: 2.9-20.2) per mIU/L (p<0.001). Cycle outcome and pregnancy rate were also similar. Conclusion Serum TSH exceeds the threshold of 2.5 mIU/L during COH in one out of three women who are euthyroid prior to enter an IVF cycle. Further evidence is warranted to elucidate the clinical relevance of our findings.
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Ovarian stimulation for assisted reproduction procedures is associated with an estrogen rise.
“particular attention should also be given to the ovarian stimulation for assisted reproduction procedures because of the associated estrogen rise (61).”
From The diagnosis and management of central hypothyroidism in 2018 (2019) · cites this paper as [61]
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What is the impact of thyroid cancer history on in vitro fertilization: A cohort studyPreprint
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- Authors
- Benaglia, L., Busnelli, A., Somigliana, E., Leonardi, M., Vannucchi, G., De Leo, S., Fugazzola, L., Ragni, G., & Fedele, L.
- Affiliations
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- University of Milan (IT)
- Corresponding author
- Busnelli, Andrea
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 2014-02
- Volume
- 173
- Pages
- 53-57
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- OpenAlex
- W2087417682
- Cited by
- 46
- References
- 21
- Citations by year
- 2024: 2 · 2023: 4 · 2022: 4 · 2021: 8 · 2020: 5 · 2019: 6 · 2018: 3 · 2017: 1 · 2016: 5 · 2015: 7 · 2014: 1
- FWCI
- 3.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- thyroid-stimulating hormone, controlled ovarian stimulation, in vitro fertilization, euthyroid women, hCG administration, TSH threshold, pregnancy rate
- MeSH terms
- Adult, Female, Fertilization in Vitro, Humans, Ovulation Induction, Predictive Value of Tests, Pregnancy, Prospective Studies, Thyrotropin, Pregnancy Rate
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