The success
rate of in vitro fertilization of oocytes is reduced in women with
high serum thyrotropin values
(November 2003)
The background of the study. Hypothyroidism
may reduce fertility. To determine whether hypothyroidism reduces
the rate of success of assisted reproduction, serum thyrotropin
(TSH) was measured in a large group of infertile women undergoing
this procedure.
How the study was done. Serum TSH
was measured in 509 women with infertility who underwent assisted
reproduction, consisting of controlled ovarian stimulation, retrieval
of oocytes, in vitro fertilization, and transfer of embryos to the
woman's uterus. The main outcomes were the frequency of successful
oocyte retrieval, fertilization, and implantation; clinical pregnancy;
spontaneous abortion; and live birth during the first cycle of treatment.
The results of the study. The causes
of infertility were tubal infertility in 118 women (23 percent),
male factor infertility in 92 women (18 percent), endometriosis
in 74 women (14 percent), ovulatory dysfunction in 54 women (11
percent), and other or unexplained in 171 women (34 percent).
The serum TSH concentrations were similar in the 30 percent of
women who became pregnant and the 70 percent who did not. Serum
TSH concentrations were higher in the women whose oocytes were not
fertilized, but not in the women from whom oocytes were not retrieved,
those in whom the embryo did not implant, or those who had spontaneous
abortions.
The conclusions of the study. High
serum TSH concentrations are associated with decreased in vitro
fertilization of oocytes in women with infertility.
The original article. Cramer DW,
Sluss PM, Powers RD, McShane P, Ginsburg ES, Hornstein MD, Vitonis
AF, Barbieri RL. Serum prolactin and TSH in an in vitro fertilization
population: is there a link between fertilization and thyroid function?
J Assist Reprod Genet 2003;20:210-5.
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