Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Preconceptional TSH & TPO Antibodies & Live Birth Rates

Fertil Steril; ePub 2017 Oct 25; Seungdamrong, et al

Among infertile women, preconceptional thyroid-stimulating hormone (TSH) ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, antithyroid peroxidase (TPO) antibodies are associated with increased risk of miscarriage and decreased probability of live birth. This according to a secondary analysis of data from 2 multicenter, randomized, controlled trials with multivariable logistic regression analyses performed to assess the association between preconceptional TSH levels and anti-TPO antibodies. Serum samples from 1,468 infertile women were utilized with cumulative conception, clinical pregnancy, miscarriage, and live birth rates calculated. Researchers found:

  • Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs TSH <2.5 mIU/L.
  • Women with anti-TPO antibodies had similar conception rates but higher miscarriage rates and lower live birth rates vs those without anti-TPO antibodies.
  • There were elevated odds of miscarriage (OR, 2.17) and lower odds of live birth (OR, 0.58) in patients with anti-TPO antibodies.
Citation:

Seungdamrong A, Steiner AZ, Gracia CR, et al. Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women. [Published online ahead of print October 25, 2017]. Fertil Steril. doi:10.1016/j.fertnstert.2017.08.026.

This Week's Must Reads

ACOG Discourages Direct-to-Consumer Genetic Testing, Obstet Gynecol; ePub 2017 Nov; ACOG

Interpregnancy Interval After Pregnancy Loss, Obstet Gynecol; ePub 2017 Nov 3; Sundermann, et al

Opioid Prescribing & Patient Use After Hysterectomy, Obstet Gynecol; ePub 2017 Nov 3; As-Sanie, et al

IUD Retention After Cesarean or Vaginal Delivery, Contraception; ePub 2017 Nov 8; Colwill, et al

Discontinuation of Oral HT & Sexual Activity, Menopause; ePub 2017 Nov 6; Gass, et al

Must Reads in Reproductive Endocrinology

Preconceptional TSH & TPO Antibodies & Live Birth Rates, Fertil Steril; ePub 2017 Oct 25; Seungdamrong, et al

Is Early Diabetes Screening in Pregnancy Underutilized?, Obstet Gynecol; ePub 2017 Oct 6; Mission, et al

Delivery BMI & Neonatal Morbidity Outcomes , Obstet Gynecol; ePub 2017 Oct 6; Kim, et al

Maternal Beverage Intake and IVF Outcomes, Fertil Steril; ePub 2017 Oct 4; Machtinger, et al

High Pregnancy Rates with Single Embryo Transfer, Fertil Steril; ePub 2017 Sep 16; Mersereau, et al