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.


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

Second-Stage Duration & Outcomes After Prior CD, Obstet Gynecol; ePub 2018 Feb 5; Hehir, et al

Antihypertensive Med Use to Treat Preeclampsia, Obstet Gynecol; ePub 2018 Feb 5; Cleary, et al

Self-Reporting Hormonal Contraceptive Use & HIV, Contraception; ePub 2018 Feb 2; Pyra, et al

Cancer Tx and Infertility Risk in Women with PCOS, Fertil Steril; ePub 2018 Feb 7; Shandley, et al

ACOG Offers Guidance on Management of GDM, Obstet Gynecol; ePub 2018 Feb; ACOG, Turrentine

Must Reads in Reproductive Endocrinology

Cancer Tx and Infertility Risk in Women with PCOS, Fertil Steril; ePub 2018 Feb 7; Shandley, et al

Fasting Glucose Levels & Reproductive History , Gynecol Endocrinol; ePub 2018 Jan 24; Wallace, et al

Rates of Preterm Delivery in ICSI vs IVF, Obstet Gynecol; ePub 2018 Jan 9; Keyhan, et al

Social Determinants of Health in Reproductive Care, Obstet Gynecol; ePub 2018 Jan; ACOG, et al

Screening for Substance Misuse in Reproductive Health, Am J Obstet Gynecol; ePub 2017 Dec 13; Martino, et al