ECE2015 Guided Posters Reproduction: Female and other (7 abstracts)
Preconceptional TSH and miscarriage in infertile women submitted to IVF
Guia Vannucchi 1 , Danila Covelli 1 , Mario Renzini 3 , Claudio Brigante 3 , Giovanni Coticchio 3 , Maria Beatrice Dal Canto 3 , Rubens Fadini 3 , Davide Dazzi 4 , Roberto Negro 5 & Laura Fugazzola 1,
1Endocrine Unit, Fondazione IRCCS Cà Granda, Milan, Italy; 2Department of Transplant, University of Milan, Milan, Italy; 3Center of Reproduction Medicine Biogenesi, Istituti Clinici Zucchi, Monza, Italy; 4Internal Medicine, Ospedale di Fidenza, Fidenza, Italy; 5Division of Endocrinology, ‘V. Fazzi’ Hospital, Lecce, Italy.
It is known that high levels of TSH are associated with higher miscarriage risk, though the precise TSH cut-offs are debated. Aim of the present study was to evaluate if pre-conceptional TSH levels associate with increased risk of early miscarriage in a large series of infertile women submitted to IVF and to determine the threshold of TSH associated with the highest prevalence of pregnancy loss. We retrospectively studied 1484 infertile women (mean±age 36.7±4.1 years, mean±S.D. BMI 22.7±4) submitted to IVF in a single center from 2004 to 2014.
Overall, 371/1484 (25%) patients had a biochemical pregnancy and 152 of them experienced a pregnancy loss. Mean TSH levels of women with a regular pregnancy were significantly lower than mean TSH levels recorded in patients with a pregnancy loss (1.8±0.8 vs 2.2±1.2, P=0.01). Interestingly, the miscarriage rate was progressively higher for increasing TSH cut-off levels (≤2.5 vs >2.5 P=0.08; ≤3 vs >3 P=0.001; ≤4.5 vs ≥4.5 P=0.004). Moreover, among the 152 women with pregnancy loss, 59 (39%) were clinically pregnant and had a miscarriage in the first trimester, while in 93 patients (61%) a biochemical pregnancy without clinical evolution was documented, but no significant differences in mean TSH levels were recorded between women with different time of miscarriage.
In conclusion, in women undergoing IVF, lower TSH levels reduce the risk of early pregnancy loss. These data strongly indicate the need for TSH screening prior to IVF procedures, and suggest the treatment of women with TSH levels >3 mU/l.
Volume 37
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Endocrine Abstracts
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