Positive effects of thyroid replacement therapy on assisted reproductive technology outcomes in women with subclinical hypothyroidism with positive thyroid peroxidase autoantibodies

Himanshu Arora, Ineabelle Collazo, Katherine L. Palmerola, Madhumita Parmar, Manish Narasimman, Nicholas Hendon, Juergen Eisermann, Maria Bustillo

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To study the beneficial effects of thyroid replacement therapy (TRT) on pregnancy outcomes in patients with subclinical hypothyroidism (SCl hypoT) with respect to thyroid peroxidase (TPO) autoantibodies. Design: Retrospective study of 706 patients. Setting: Not applicable. Patient(s): The study evaluated 706 patients, who were divided into 3 cohorts: euthyroid patients, with pre–in vitro fertilization thyroid-stimulating hormone levels of <2.5 μIU/mL; patients with SCl hypoT, defined as thyroid-stimulating hormone levels of >2.5 μIU/mL and <4 μIU/mL, who were not treated; and patients with SCl hypoT who received TRT. The 3 cohorts were further subclassified into 2 groups, each based on TPO antibody levels. Intervention(s): The cohorts were compared for the effects of TRT on pregnancy outcomes. Main Outcome Measure(s): Identification of effects of TRT on assisted reproductive technology outcomes. Result(s): Patients with SCl hypoT had significantly fewer positive pregnancy outcomes than euthyroid patients. Importantly, low-dose TRT was found to be beneficial in improving IVF success and pregnancy outcomes in patients with SCl hypoT. The original cohort of patients, further classified into 2 subgroups on the basis of antithyroid (TPO) antibodies, showed that low-dose TRT was associated with improved pregnancy outcomes in women with SCl hypoT and TPO-positive antibodies. Conclusion(s): Our findings demonstrate that low-dose TRT may be beneficial in improving in vitro fertilization success and pregnancy outcomes in women with SCl hypoT and TPO-positive antibodies.

Original languageEnglish (US)
Pages (from-to)32-38
Number of pages7
JournalF and S Reports
Volume3
Issue number1
DOIs
StatePublished - Mar 2022
Externally publishedYes

Keywords

  • Subclinical hypothyroidism
  • in vitro fertilization
  • thyroid replacement therapy

ASJC Scopus subject areas

  • Embryology
  • Obstetrics and Gynecology
  • Reproductive Medicine

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