Hum. Reprod. Advance Access originally published online on May 5, 2005
Human Reproduction 2005 20(6):1529-1533; doi:10.1093/humrep/deh843
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Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study
1 Department of Internal Medicine, 2 Department of Obstetrics and Gynecology, Division of Physiopathology of Human Reproduction, Casa di Cura ‘Salus’, Brindisi, 3 Department of Internal Medicine, District Hospital, Fidenza, Italy and 4 Endocrine Unit, RIPAS Hospital, Bandar Seri Begawan, Brunei
5 To whom correspondence should be addressed at: Department of Endocrinology, District Hospital ‘Vito Fazzi’, Piazza F. Muratore 73100 Lecce, Italy. Email: robnegro{at}tiscali.it
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.
Key words: assisted reproductive technologies/autoimmunity/levothyroxine/thyroid
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