title: Preconceptional thyroid-stimulating hormone levels and outcomes of intrauterine insemination among euthyroid infertile women.
abstract: OBJECTIVE
  To evaluate differences in intrauterine insemination (IUI) outcomes among euthyroid women with preconceptional thyroid-stimulating hormone (TSH) values in the normal (0.4-2.4 mIU/L) and high-normal (2.5-4.9 mIU/L) ranges.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  A single fertility center.
  
  
  METHODS
  A total of 1,477 women who underwent 4,064 IUI cycles between the years 2004 and 2012.
  
  
  METHODS
  None.
  
  
  METHODS
  Live birth, clinical pregnancy, spontaneous abortion (SAB), and IUI cycle parameters.
  
  
  RESULTS
  Cycles were categorized into 4 groups based on preconceptional TSH values: 0.40-1.36 mIU/L; 1.37-1.86 mIU/L; 1.87-2.49 mIU/L; and 2.50-4.99 mIU/L. No statistically significant differences were found in IUI cycle parameters, clinical pregnancy rates, or live births per initiated cycle among the 4 TSH groups. However, preconceptional TSH was inversely related to SAB and positively related to live birth among women who achieved a clinical pregnancy. In this group of women, cycles with TSH values between 2.5 and 4.9 mIU/L were related to lower odds of SAB (odds ratio: 0.32; 95% confidence interval: 0.16-0.65) and higher odds of live birth (odds ratio: 2.80; 95% confidence interval: 1.43-5.48) compared with cycles among women in the lowest TSH group.
  
  
  CONCLUSIONS
  Among euthyroid patients, preconceptional TSH values in the high-normal range (between 2.5 and 4.9 mIU/L) are not associated with adverse IUI outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Reproductive Endocrinology and Infertility Division, Harvard Medical School, Boston, Massachusetts. Electronic address: akarmon@mgh.harvard.edu.
authors.forename: Anatte E
authors.initials: AE
authors.lastname: Karmon
authors.affiliation: Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Reproductive Endocrinology and Infertility Division, Harvard Medical School, Boston, Massachusetts.
authors.forename: Maria
authors.initials: M
authors.lastname: Batsis
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Chavarro
authors.affiliation: Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Reproductive Endocrinology and Infertility Division, Harvard Medical School, Boston, Massachusetts.
authors.forename: Irene
authors.initials: I
authors.lastname: Souter
mesh_terms: D000328:Adult; D001900:Boston / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood* / Q000453:epidemiology*; D007247:Infertility, Female / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D007315:Insemination, Artificial / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D015995:Prevalence; D013972:Thyrotropin; D016896:Treatment Outcome
chemical_list: D013972:Thyrotropin
keywords: Thyroid-stimulating hormone; infertility; intrauterine insemination; miscarriage; spontaneous abortion