title: Do elevated TSH levels predict early pregnancy loss in ART patients?
abstract: BACKGROUND
  The upper limit of normal TSH has been revised from 5 mIU/L to 2.5 mIU/L. We sought to evaluate IVF patients and the association between abnormal TSH and early pregnancy loss.
  
  
  METHODS
  A retrospective study of patients who had TSH levels measured within the 2 weeks prior to their fresh autologous IVF cycles (2002-2014). Cohorts were stratified by oocyte age (<35, [35-38), [38-41), [41-43) and ≥43 years), and TSH level [(0-0.5], (0.5-2.5], (2.5-5], and (5-23) mIU/L]. Patients were followed until pregnancy loss or delivery. Model was assessed by chi-square of ANOVA with significance at p < 0.05.
  
  
  RESULTS
  TSH was abnormally elevated (>5 mIU/L), mildly elevated ((2.5-5] mIU/L) or suppressed (≤0.5 mIU/L) in 46, 317 and 65 of the 1201 total cycles, respectively. Treatment resulted in 630 pregnancies, 524 clinical pregnancies and 409 deliveries. Pregnancy loss rates were increased in patients ≥38 yo (p < 0.001) but not [35-38) yo (p = 0.40) compared with those <35 yo. Early pregnancy loss rate was not associated with TSH level (p > 0.30) compared with euthyroid patients after adjusting for oocyte age.
  
  
  CONCLUSIONS
  Early pregnancy loss rate in IVF patients appears to have no relation to recent TSH levels.
authors.affiliation: a Reproductive Medicine Associates of New York , New York , NY , USA.|b Department of Obstetrics , Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai , New York , NY , USA , and.|c Obstetrics/Gynecology and Women's Health Institute, Cleveland Clinic Foundation , Cleveland , OH , USA.
authors.forename: Julian A
authors.initials: JA
authors.lastname: Gingold
authors.affiliation: b Department of Obstetrics , Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai , New York , NY , USA , and.
authors.forename: Kelly
authors.initials: K
authors.lastname: Zafman
authors.affiliation: a Reproductive Medicine Associates of New York , New York , NY , USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Rodriguez-Purata
authors.affiliation: a Reproductive Medicine Associates of New York , New York , NY , USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Whitehouse
authors.affiliation: a Reproductive Medicine Associates of New York , New York , NY , USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Lee
authors.affiliation: a Reproductive Medicine Associates of New York , New York , NY , USA.|b Department of Obstetrics , Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai , New York , NY , USA , and.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Sandler
authors.affiliation: a Reproductive Medicine Associates of New York , New York , NY , USA.|b Department of Obstetrics , Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai , New York , NY , USA , and.
authors.forename: Alan B
authors.initials: AB
authors.lastname: Copperman
mesh_terms: D000022:Abortion, Spontaneous / Q000097:blood*; D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood*; D055815:Young Adult
chemical_list: D013972:Thyrotropin
keywords: Early pregnancy loss; euthyroid; in vitro fertilization; subclinical hypothyroidism; thyroid stimulating hormone