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Thyroid function during ovarian stimulation: a systematic review.
Gesthimani Mintziori1, Dimitrios G Goulis, Konstantinos A Toulis
1Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Fertility and Sterility
|July 12, 2011
Summary
Ovarian stimulation (OS) may impact thyroid function, with some studies showing increased thyroid-stimulating hormone (TSH) levels. However, evidence on thyroid autoimmunity (TAI) changes remains inconclusive, necessitating further research.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Immunology
Background:
- Thyroid function and autoimmunity are crucial for reproductive health.
- Ovarian stimulation (OS) is a common treatment for infertility.
- The effects of OS on thyroid parameters are not fully understood.
Purpose of the Study:
- To systematically review existing evidence on changes in thyroid function and thyroid autoimmunity (TAI) in women undergoing OS.
- To assess the impact of OS on thyroid-stimulating hormone (TSH), thyroid hormones, and thyroid antibodies.
Main Methods:
- Systematic review of seven studies published between 2000 and 2011.
- Inclusion criteria: studies reporting thyroid function or TAI data before and during or after OS.
- Outcome measures included serum TSH, free thyroxine, free tri-iodothyronine, and thyroid antibodies.
Main Results:
- Inconsistent changes observed in serum TSH and free thyroxine levels across studies.
- Free tri-iodothyronine levels remained unchanged in the single study measuring them.
- Thyroid antibody concentrations showed no significant changes in most studies, despite alterations in thyroid function.
Conclusions:
- Current evidence is inconclusive regarding the effect of OS on thyroid function and TAI.
- Elevated TSH levels post-OS may exceed pregnancy thresholds, warranting caution.
- Further prospective studies are needed to determine the necessity of routine thyroid evaluation in women undergoing OS.
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