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THE LONG-TERM IMPACT OF CONTROLLED OVARIAN HYPERSTIMULATION ON THYROID FUNCTION.

Andrea Busnelli, Edgardo Somigliana, Stefania Ferrari

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    |November 18, 2015
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    Controlled ovarian hyperstimulation (COH) may impact thyroid-stimulating hormone (TSH) levels long-term. This effect is more significant in women with hypothyroidism undergoing in vitro fertilization (IVF).

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    Area of Science:

    • Reproductive Endocrinology
    • Thyroidology

    Background:

    • Limited evidence exists on the long-term effects of controlled ovarian hyperstimulation (COH) on thyroid function.
    • Thyroid-stimulating hormone (TSH) levels are critical for reproductive success and overall health.

    Purpose of the Study:

    • To investigate serum TSH modifications in euthyroid and hypothyroid women during and after COH.
    • To assess the long-term impact of COH on thyroid function in women undergoing in vitro fertilization (IVF).

    Main Methods:

    • A case-control study included women undergoing IVF who did not achieve pregnancy.
    • Cases were women with treated hypothyroidism and controls were euthyroid women, matched for age and basal TSH.
    • Serum TSH was measured at four time points: before COH, during hCG administration, 16 days post-hCG, and 3 months after the IVF cycle.

    Main Results:

    • Serum TSH levels were significantly higher at 3 months post-IVF compared to pre-COH levels in both groups (P<.001).
    • At 3 months post-IVF, 51% of hypothyroid women and 16% of euthyroid women had TSH levels exceeding the 2.5 mIU/L threshold.
    • A statistically significant difference in TSH levels was observed at 3 months post-cycle between cases and controls (P = .003).

    Conclusions:

    • COH appears to exert a long-term influence on serum TSH levels.
    • The impact of COH on TSH is notably more pronounced in women with pre-existing hypothyroidism.
    • These findings suggest the need for careful thyroid function monitoring in women undergoing COH, especially those with hypothyroidism.