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Prior iodine exposure and impact on thyroid function during controlled ovarian hyperstimulation: A prospective study.

Rachel A Bradbury1,2,3, Darshika Christie-David3,4, Howard C Smith1,2

  • 1Westmead Fertility Centre, Westmead Hospital, Sydney, New South Wales, Australia.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
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Long-term iodine supplementation may impair thyroid adaptation during controlled ovarian hyperstimulation (COH). Women taking iodine for over six months showed reduced thyroid function, impacting live birth rates.

Keywords:
iodineovarian inductionpregnancythyroid hormone

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Area of Science:

  • Reproductive Endocrinology
  • Thyroid Physiology
  • Infertility Treatment

Background:

  • Iodine supplementation is recommended for pregnancy planning.
  • The effect of iodine on thyroid function during controlled ovarian hyperstimulation (COH) is not well understood.
  • Thyroid health is crucial for successful conception and pregnancy.

Purpose of the Study:

  • To investigate the impact of iodine supplementation on thyroid function during COH.
  • To compare thyroid hormone levels in women with varying iodine intake during COH.
  • To assess the relationship between iodine intake, thyroid function, and fertility outcomes.

Main Methods:

  • 106 euthyroid women undergoing their first COH cycle were studied.
  • Participants were grouped by iodine supplementation duration (<6 months, ≥6 months) and compared to levothyroxine-treated controls.
  • Thyroid stimulating hormone (TSH), free thyroxine, free triiodothyronine, and thyroglobulin levels were monitored at multiple time points during COH.

Main Results:

  • TSH levels increased significantly in women taking iodine for ≥6 months and in levothyroxine-treated controls.
  • One-quarter of participants taking iodine had TSH >2.5 mIU/L before embryo transfer.
  • While iodine supplementation did not affect oocyte yield or fertilization, women taking iodine for <6 months had higher live birth rates.

Conclusions:

  • Prolonged iodine supplementation (≥6 months) may hinder thyroid adaptation to COH demands.
  • Thyroid responses in long-term iodine users resemble those of levothyroxine-dependent patients.
  • Optimal iodine intake timing is crucial for women undergoing COH to support thyroid function and improve pregnancy outcomes.