Endocrine Abstracts

Introduction: Progress in the field of infertility research and an increasing number of In Vitro Fertilizations (IVF) with intensive approach to sterility has opened new doubts about the impact of thyroid gland in the conception as well as pregnancy outcomes. Standard access to the levels of TSH and interpretation values as subclinical or clinical forms of hypothyroidism in this population has not proved to be quite correct.After the IVF guidelinesses begun to emphasize the amount of TSH of 2.5 mIU / l as the preferred upper limit for IVF, often have changes in thyrologists approach to this problem. The appearance of new organ (placenta) and intensive deiodinase activity is changing thyroid hormone metabolism.

Objective: Prove that correction of normal-high TSH values from 2.5 to 6.0 mIU /l with levothyroxine to below 2.5 mIU /l has an impact on the outcome of pregnancy. Discuss different mechanisms that might affect pregnancy outcome.

Materials and methods: Retrospectively in the last 8 years, a group of 60 patients who were at least two years in marriage and with the diagnosis of infertility, previously not given birth, were subjected to various procedures (VTO, insemination, etc.) and investigation group has not been previously treated for therapy thyroid gland diseases. From this group we excluded women with known tendency to thrombophilya and proven hyperprolactinemia. Patients had initial TSH levels (TSH1) of 2.5 to 6.0 mIU /l and normal T4 values, were treated with levothyroxine to TSH suppression below 2.5 mIU/l. Determined last TSH (TSH2) before pregnancy. During pregnancy, all patients maintained TSH levels below 2.5 mIU /l. Followed by the outcome of the pregnancy, which is regarded as: delivered, miscarriage, no pregnancy.

Results: Forty-three patients (71.6%) delivered successfully, 13 patients (21.6%) got pregnant but had a miscarriage, 4 had not got pregnant (6.66%) p(TSH1)=0,751 , p(TSH2)=0,580

Conclusion: During the follow-up of this group of respondents, obtained a high number of successfully conceived and delivered pregnancies (71.6%), the number of spontaneous miscarriages was discreetly higher than in the general population. It might happened that changes in deiodinase activity are the reason for these results or some other mechanism (TSH independent).