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Curr Opin Obstet Gynecol. 2016 Jun;28(3):191-7. doi: 10.1097/GCO.0000000000000263.

Thyroid function and IVF outcome: when to investigate and when to intervene?

Author information

1
aUnit of Reproductive Endocrinology bUnit of Human Reproduction, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece.

Abstract

PURPOSE OF REVIEW:

To summarize the evidence regarding the need to assess thyroid function in women undergoing ovarian stimulation as well as the need to intervene when thyroid function is suboptimal.

RECENT FINDINGS:

There is now evidence that ovarian stimulation can influence thyroid function not only via hyperestrogenism but also directly, since thyroid-related receptors are present in human granulosa cells and in the endometrium. Prospective and retrospective observational studies, as well as a few clinical trials, have been conducted in an effort to clarify the association between ovarian stimulation and thyroid function with controversial results.

SUMMARY:

The need of thyroid function screening with thyroid stimulating hormone (TSH) in infertile women attempting pregnancy is recognized by many international societies. Since TSH is a simple, cheap screening tool and levothyroxine (LT4) supplementation is an easy to apply, cheap and well tolerated intervention, universal thyroid screening in women undergoing IVF represents a reasonable policy. In case of subclinical hypothyroidism, when TSH exceeds the threshold of 4.0 or 4.5 μIU/ml before IVF, LT4 replacement should be administered, while the same intervention might also be justified for women with TSH concentration more than 2.5 μIU/ml before IVF.

PMID:
26967594
DOI:
10.1097/GCO.0000000000000263
[Indexed for MEDLINE]

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