title: Effect of levothyroxine treatment on in vitro fertilization and pregnancy outcome in infertile women with subclinical hypothyroidism undergoing in vitro fertilization/intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To investigate whether levothyroxine (LT4) treatment has beneficial effects on IVF results and pregnancy outcome in infertile patients with subclinical hypothyroidism undergoing IVF/intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Prospective, randomized trial.
  
  
  METHODS
  University-affiliated infertility clinic.
  
  
  METHODS
  A total of 64 infertile patients with subclinical hypothyroidism, defined as an elevated serum TSH level associated with a normal free T4 level and without frank symptoms of hypothyroidism.
  
  
  METHODS
  Patients were randomized into an LT4 treatment group or control group. For the LT4 treatment group, 50 μg LT4 was administered from the first day of controlled ovarian stimulation for IVF/ICSI.
  
  
  METHODS
  Results of IVF and pregnancy outcome.
  
  
  RESULTS
  There were no differences in patient characteristics between the two groups. Total dose and days of recombinant human FSH used for controlled ovarian stimulation were also similar. The number of grade I or II embryos was significantly higher in the LT4 treatment group than in the control group. There was no significant difference in the clinical pregnancy rate per cycle between the two groups. However, the miscarriage rate was significantly lower in the LT4 treatment group than in the control group. Embryo implantation rate and live birth rate were significantly higher in the LT4 treatment group. In the control group, both thyroid peroxidase antibody and thyroglobulin antibody levels were significantly higher in the miscarried subgroup than in the delivered subgroup.
  
  
  CONCLUSIONS
  LT4 treatment can improve embryo quality and pregnancy outcome in subclinical hypothyroid women undergoing IVF/ICSI.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea. chnkim@amc.seoul.kr
authors.forename: Chung-Hoon
authors.initials: CH
authors.lastname: Kim
authors.forename: Jun-Woo
authors.initials: JW
authors.lastname: Ahn
authors.forename: Sunjung Park
authors.initials: SP
authors.lastname: Kang
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Hee-Dong
authors.initials: HD
authors.lastname: Chae
authors.forename: Byung-Moon
authors.initials: BM
authors.lastname: Kang
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D005260:Female; D005306:Fertilization / Q000187:drug effects / Q000502:physiology; D005307:Fertilization in Vitro / Q000187:drug effects* / Q000379:methods; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000188:drug therapy*; D007247:Infertility, Female / Q000150:complications / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D013974:Thyroxine / Q000627:therapeutic use*
chemical_list: D013974:Thyroxine