Female infertility – the role of thyroid autoimmunity in assisted reproductive technology.

Student thesis: Doctoral Thesis

Abstract

Thyroid auto-immunity (TAI) and/or thyroid dysfunction are prevalent in women of reproductive age, and have independently been associated with adverse fertility and pregnancy outcomes. However, data regarding the outcome of fertility treatment in the presence of thyroid autoimmunity are conflicting and the optimal upper value of TSH in the presence or the absence of thyroid autoimmunity (TAI) remains controversial. Moreover, data on the prevalence of TAI as defined by the presence of Tg-abs are scarce, as well as data of the effect of these antibodies on thyroid function in the case of spontaneous pregnancy as in the case of ART.
The present thesis shows that TAI is more frequent in infertile women compared to fertile controls. Five percent of women consulting at our Centre for Reproductive Medicine (CRG) had isolated positive Tg-abs and a higher serum TSH compared to women without TAI. These TAI-positive patients would have been missed by the measurement of TPO-abs only. Furthermore, our findings indicate comparable live birth delivery -, pregnancy and abortion rates in women with and without thyroid autoimmunity undergoing ART. We were unable to confirm a negative effect of TSH level above 2.5 mIU/L on live birth delivery rate. Therefore, our data suggest that women with TSH levels within the normal non- pregnant range may not need treatment with levothyroxine.
Date of Award15 Jun 2017
Original languageEnglish
Awarding Institution
  • Vrije Universiteit Brussel
SupervisorBrigitte Velkeniers-Hoebanckx (Promotor), Michaël De Brucker (Promotor), Willem Verpoest (Jury), Nico De Leu (Jury), Inge Gies (Jury), A.R.M.M. Hermus (Jury) & B Corvilain (Jury)

Keywords

  • infertility
  • Female
  • thyroid autoimmunity
  • assisted reproductive technology
  • age
  • fertility

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