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Thyroxine replacement during super-ovulation for in vitro fertilization: a potential gap in management?

Abstract：

OBJECTIVE:Our objective is to report observed changes in thyroid-stimulating hormone (TSH) in two patients undergoing super-ovulation for IVF. DESIGN:Case report. SETTING:Private assisted reproduction practices. PATIENT(S):Two hypothyroid women taking thyroxine replacement therapy undergoing super-ovulation for IVF. INTERVENTION(S):Laboratory records for TSH taken during ovulation induction cycles were retrieved retrospectively for six cycles and measured prospectively for one cycle each in both women. MAIN OUTCOME MEASURE(S):To document changes in thyroid status during super-ovulation. RESULT(S):Despite being euthyroid at the start of the super-ovulation cycle, both patients demonstrated a rise in TSH to hypothyroid levels during ovulation induction, even in the absence of ongoing pregnancy. CONCLUSION(S):High circulating E(2) during super-ovulation for IVF induces increased thyroxine-binding globulin binding of thyroxine. In women taking thyroxine replacement therapy, hypothyroidism develops during a super-ovulation cycle. Whether such acute biochemical hypothyroidism is a hindrance to ovum quality, fertilization, conception, or ongoing pregnancy and whether thyroxine dose adjustment during a super-ovulation cycle would improve IVF outcomes requires further study. These case studies identify a potential management gap in assisted reproduction for women taking thyroxine therapy.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Stuckey BG,Yeap D,Turner SR

doi

10.1016/j.fertnstert.2009.11.051

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

2414.e1-3

issue

7

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(09)04143-0

journal_volume

93

pub_type

杂志文章

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