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Extra-low dose levothyroxine improves pregnancy outcomes in women with subclinical hypothyroidism undergoing IVF

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-12-14T10:15:33+05:30  |  Updated On 14 Dec 2023 12:09 PM IST
Extra-low dose levothyroxine improves pregnancy outcomes in women with subclinical hypothyroidism undergoing IVF
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Extra-low dose levothyroxine improves pregnancy outcomes in women with subclinical hypothyroidism undergoing IVF suggests a new study published in the Taiwanese Journal of Obstetrics and Gynecology

This study was undertaken to test the therapeutic effect of extra-low dose of levothyroxine (LT4; 25 mcg/day) to preconception and pregnant women with subclinical hypothyroidism (SCH).

This is a retrospective study, SCH women who succeeded in their first in vitro fertilization (IVF) cycle between January 1, 2018, to December 31, 2020 were included. SCH is defined as normal serum free thyroxine (T4) level and an elevated serum thyroid stimulating hormone (TSH) level >4 mIU/L. Extra-low dose of levothyroxine (LT4; 25 mcg/day) was prescribed to the SCH women from the establish of diagnosis of SCH to the end of pregnancy. The pregnancy outcomes (miscarriage, live birth, preterm birth, and small for gestational age baby) were compared to the euthyroid pregnant women.

Results:

Totally, 589 women were screened, and 317 cases received their first time IVF treatment. 167 women were clinically pregnant after IVF treatment, 155 of them were euthyroid and 12 of these women were diagnosed to have SCH. The average age of the participants was 35 years old. There were no significant differences in age, body mass index (BMI), anti-müllerian hormone (AMH), types of embryo transfer, number of embryos to transfer, or embryo stage during transfer between two groups. The live birth rate, miscarriage rate, and preterm birth rate in women with SCH supplemented with extra-low dose of LT4 were non-inferior to euthyroid patients (miscarriage rate: P = 0.7112; live birth rate: P = 0.7028; preterm delivery: P = 0.2419; small for gestational age: P = 0.2419).

The result demonstrated that supplementation with extra-low dose of levothyroxine at 25 mcg/day to SCH women can produce the comparable obstetrical and neonatal outcome as that in euthyroid pregnant women. Accordingly, we suggest extra-low-dose of levothyroxine may be considered as a safe and effective alternative for those SCH pregnant women who were not tolerated to the standard dose of levothyroxine.

Reference:

Chen YT, Ho CH, Chung MT, Wen JY, Lin YL, Hsiao TW, Tsai YC. Effect of extra-low dose levothyroxine supplementation on pregnancy outcomes in women with subclinical hypothyroidism undergoing in vitro fertilization and embryo transfer. Taiwan J Obstet Gynecol. 2023 Nov;62(6):869-873. doi: 10.1016/j.tjog.2023.05.014. PMID: 38008507.

Keywords:

Extra-low, dose, levothyroxine, improves, ancy, outcomes, women, subclinical, hypothyroidism, undergoing, IVF, Chen YT, Ho CH, Chung MT, Wen JY, Lin YL, Hsiao TW, Tsai YC, Infertility; In vitro fertilization and embryo transfer; Levothyroxine; Pregnancy outcome; Subclinical hypothyroidism.

levothyroxinesubclinicalhypothyroidismundergoingIVFTaiwanese Journal of Obstetrics and GynecologyPregnancy outcomes
Source : Taiwanese Journal of Obstetrics and Gynecology
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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