title: Thyroxine treatment may be useful for subclinical hypothyroidism in patients with female infertility.
abstract: Infertile women sometimes associated with subclinical hypothyroidism (SCH). The guidelines of the American Endocrine Society, and American Association of Clinical Endocrinologists and American Thyroid Association recommend treatment with thyroxine (T4) for patients with SCH who want to have children. We examined 69 female infertile patients with SCH and the effects of levothyroxine (l-T4) therapy on pregnancy rates and pregnancy outcomes were observed. Fifty-eight (84.1%) patients successfully conceived during the T4 treatment period (Group A), although 17 patients (29.3%) had miscarriage afterward. The remaining 11 patients continued to be infertile (Group B). The median TSH value in Group A before the T4 treatment was 5.46 μIU/mL (range 3.1-13.3) and this significantly decreased to 1.25 μIU/mL (range 0.02-3.75) during the treatment (p<0.001). The estimated duration of infertility before the T4 treatment was 2.8±1.7 years and the duration until pregnancy after the treatment was significantly shorter at 0.9±0.9 years (p<0.001). Shortening of the infertile period after the T4 therapy was observed not only in patients who were treated with assisted reproductive technology (ART) but also in patients who conceived spontaneously in Group A. Administered T4 dose was 54.3±14.2 μg before pregnancy and 68.5±22.8 μg during pregnancy (p<0.001). Anti-thyroid autoantibodies were identified in 42.0% of all patients and no significant difference was observed in positivity between Group A and Group B. High successful pregnancy rate and shorter duration of infertility until pregnancy after T4 treatment strongly suggest that T4 enhanced fertility in infertile patients with SCH.
authors.affiliation: Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan.
authors.forename: Waka
authors.initials: W
authors.lastname: Yoshioka
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Amino
authors.forename: Akane
authors.initials: A
authors.lastname: Ide
authors.forename: Shino
authors.initials: S
authors.lastname: Kang
authors.forename: Takumi
authors.initials: T
authors.lastname: Kudo
authors.forename: Eijun
authors.initials: E
authors.lastname: Nishihara
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ito
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology / Q000517:prevention & control; D000328:Adult; D058070:Asymptomatic Diseases; D001323:Autoantibodies / Q000032:analysis; D010065:Embryo Implantation, Delayed / Q000187:drug effects; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D007564:Japan / Q000453:epidemiology; D050498:Live Birth; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted; D013961:Thyroid Gland / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000627:therapeutic use*; D061685:Time-to-Pregnancy
chemical_list: D001323:Autoantibodies; D013972:Thyrotropin; D013974:Thyroxine