title: Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study.
abstract: BACKGROUND
  Infertile women positive for thyroid antibodies suffer from a poor pregnancy/delivery outcome, although conflicting data have been published. Our objective was to investigate if levothyroxine (LT4) exerts any effect on pregnancy and/or delivery rates in thyroid peroxidase antibody (TPOAb)-positive (+) women undergoing assisted reproductive technologies.
  
  
  METHODS
  Patients undergoing treatment were screened for TPOAb, thyroid-stimulating hormone (TSH) and free thyroxine (FT4). A total of 72 (15%) out of the 484 euthyroid women selected were TPOAb (+). These 72 patients were randomly divided into two groups: group A (n = 36) underwent LT4 treatment, group B (n = 36) placebo. Group C consisted of 412 women (85%) who were TPOAb negative (-). All patients received controlled ovarian stimulation. The endpoints of treatment were pregnancy rate, miscarriage rate and delivery rate.
  
  
  RESULTS
  No differences in pregnancy rate were observed between the three groups. Miscarriage rate was higher in TPOAb (+) in comparison to TPOAb (-) [relative risk: 2.01 (95% CI = 1.13-3.56), P = 0.028].
  
  
  CONCLUSIONS
  The pregnancy rate is not affected either by presence of TPOAb or treatment with LT4. However, TPOAb (+) women show a poorer delivery rate compared to TPOAb (-). LT4 treatment in TPOAb (+) does not affect the delivery rate.
authors.affiliation: Department of Internal Medicine, Division of Physiopathology of Human Reproduction, Casa di Cura Salus, Brindisi. robnegro@tiscali.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Negro
authors.forename: Tiziana
authors.initials: T
authors.lastname: Mangieri
authors.forename: Lamberto
authors.initials: L
authors.lastname: Coppola
authors.forename: Giovanni
authors.initials: G
authors.lastname: Presicce
authors.forename: Eugenio Caroli
authors.initials: EC
authors.lastname: Casavola
authors.forename: Riccardo
authors.initials: R
authors.lastname: Gismondi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Locorotondo
authors.forename: Paolo
authors.initials: P
authors.lastname: Caroli
authors.forename: Antonio
authors.initials: A
authors.lastname: Pezzarossa
authors.forename: Davide
authors.initials: D
authors.lastname: Dazzi
authors.forename: Haslinda
authors.initials: H
authors.lastname: Hassan
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001723:Birth Rate; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D007453:Iodide Peroxidase / Q000097:blood*; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted; D013959:Thyroid Diseases / Q000188:drug therapy; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*
chemical_list: D001323:Autoantibodies; C056626:thyroid microsomal antibodies; D013972:Thyrotropin; D007453:Iodide Peroxidase; D013974:Thyroxine